Health inequalities in hepatocellular carcinoma surveillance, diagnosis, treatment, and survival in the United Kingdom: a scoping review
Mysko, Christopher Landi, Stephanie Purssell, Huw Allen, A Joy Prince, Martin Lindsay, Gary Rodrigues, Steven Irvine, Jenny Street, Oliver Gahloth, Deepankar
Mysko, Christopher
Landi, Stephanie
Purssell, Huw
Allen, A Joy
Prince, Martin
Lindsay, Gary
Rodrigues, Steven
Irvine, Jenny
Street, Oliver
Gahloth, Deepankar
Affiliation
Manchester University NHS Foundation Trust; University of Manchester; Roche Diagnostics Limited; Vocal Manchester; University of Aberdeen; University of Birmingham; University Hospitals Birmingham NHS Foundation Trust
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Publication date
2025-03-03
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Abstract
Background: Hepatocellular carcinoma (HCC) remains a deadly cancer in the UK despite advancements in curative therapies. Societal conditions and health inequalities influence the development of chronic liver disease and outcomes from complications including HCC. Scoping this emergent evidence-base is required to inform research and solutions for the NHS.
Methods: A PRISMA scoping review was performed up to September 2023. Articles exploring health inequalities in HCC involving the UK population were included.
Results: This review has characterised axes of health inequality and their impact across the HCC care continuum in the UK. Studies predominantly employed a cohort design or population-based analyses, with meta-analyses of surveillance utilisation including only a single UK study. These methodologies provided an appropriate lens to understand longitudinal trends and identify disadvantaged groups. However, important evidence gaps remain, including exploration of patient perspectives, intersectional analyses, and statistical measures of socioeconomic inequity in HCC.
Conclusions: HCC is a rapidly growing cause of cancer mortality and disproportionally affects underserved groups, presenting a major public health concern. Further research is required to innovate and evaluate surveillance and management pathways to reduce systemic inequities. Direction is needed at the national level to improve prevention, early diagnosis and access to curative treatment.
Citation
Mysko C, Landi S, Purssell H, Allen AJ, Prince M, Lindsay G, Rodrigues S, Irvine J, Street O, Gahloth D, MacLennan S, Piper Hanley K, Hanley N, Athwal VS. Health inequalities in hepatocellular carcinoma surveillance, diagnosis, treatment, and survival in the United Kingdom: a scoping review. BJC Rep. 2025 Mar 3;3(1):13.
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Article