Mysko Christopher, Landi Stephanie, Purssell Huw, Allen A Joy, Prince Martin, Lindsay Gary, Rodrigues Steven, Irvine Jenny, Street Oliver, Gahloth Deepankar, MacLennan Sara, Piper Hanley Karen, Hanley Neil, Athwal Varinder Singh
Manchester University NHS Foundation Trust, Manchester, UK.
University of Manchester, Manchester, UK.
BJC Rep. 2025 Mar 3;3(1):13. doi: 10.1038/s44276-025-00126-5.
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.
A PRISMA scoping review was performed up to September 2023. Articles exploring health inequalities in HCC involving the UK population were included.
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.
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.
尽管在根治性治疗方面取得了进展，但肝细胞癌（HCC）在英国仍然是一种致命的癌症。社会状况和健康不平等会影响慢性肝病的发展以及包括HCC在内的并发症的预后。需要梳理这一新兴的证据基础，为英国国家医疗服务体系（NHS）的研究和解决方案提供信息。
截至2023年9月进行了一项PRISMA范围综述。纳入了探讨涉及英国人群的HCC健康不平等问题的文章。
本综述描述了英国HCC护理连续过程中健康不平等的维度及其影响。研究主要采用队列设计或基于人群的分析，对监测利用情况的荟萃分析仅包括一项英国研究。这些方法为理解纵向趋势和识别弱势群体提供了合适的视角。然而，仍存在重要的证据空白，包括对患者观点的探索、交叉分析以及HCC社会经济不平等的统计指标。
HCC是癌症死亡率快速上升的一个原因，对服务不足的群体影响尤为严重，这是一个重大的公共卫生问题。需要进一步开展研究，以创新和评估监测及管理途径，减少系统性不平等。国家层面需要指导意见，以改善预防、早期诊断以及获得根治性治疗的机会。
