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Patients from disadvantaged backgrounds have less access to quality care, which generates a greater risk of death.
Less access to care, and a higher risk of death: in France, people from disadvantaged backgrounds are less well taken care of when they suffer from liver cancer, shows a study published in the specialized journal JHEP Reports And led by a team from Cochin-Port-Royal Hospital (AP-HP) associated with Paris Cité University, at the Inria Center in Paris and Inserm. According to these researchers, care in specialized centers would save 800 lives per year.
The work shows that in France differences due to social inequalities persist, both in access to curative treatments (surgery, transplantation, ablation) and in the survival of people with “primitive” liver cancer which arises directly in the liver and not in another organ.
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Researchers have analyzed data relating to 62,51 adult patients with 2017 and 2021 of “primitive” liver cancer (which arises directly in the liver and not in another organ), the third cause of cancer death in the world. About half of the patients came from disadvantaged backgrounds, according to four criteria (unemployment, manual work, level of education, income).
Centres experts
According to the study, these patients have had less often access to curative treatments (surgery, transplantation, removal) and present a higher risk of death, regardless of the distance between their home and the care center as well as the medical density of their region. On the other hand, when they were taken care of in reference hospitals, their chances of accessing curative treatment, as well as their risk of mortality, have proven to be comparable to those of favored patients.
Centralizing care in specialized expert centers would increase access to effective treatment for disadvantaged patients and reduce inequalities by 25 %, argue study authors. This would save just over 800 lives per year, calculated the authors, who call for a more ambitious public health policy to reduce social inequalities in access to care.
They also consider urgent to accentuate prevention measures (fight against alcohol, vaccination against hepatitis B, management of metabolic diseases), to better inform the general public and to train professionals more about these cancers. In the absence of preventive measures, the number of new cases of liver cancer could almost double by 2050, according to a recent report by the Commission of the Lancet on hepatocellular carcinoma (CHC).
