# Investigating the Relationship Between Racial Residential Segregation and Hepatocellular Carcinoma

> **NIH NIH F30** · MEDICAL COLLEGE OF WISCONSIN · 2020 · $31,636

## Abstract

PROJECT SUMMARY
 Liver cancer is a major contributor to cancer mortality and has major racial disparities in incidence, with
Hispanics, Asians, and Blacks all having significantly higher incidence than Whites. Survival rates for liver
cancer are among the worst across all primary sites, and there has been little improvement over time.
Therefore, investigating pathways to prevent liver cancer is likely the best approach to reduce its burden.
 Hepatocellular carcinoma (HCC) comprises the majority of all liver cancer cases. The biological
pathways underlying the development of HCC are fairly well understood, with chronic liver injury leading to
cirrhosis and oncogenic mutations. There are multiple types of liver injury which can lead to HCC, but the
major pathways include hepatitis B, hepatitis C, alcoholic liver disease, and non-alcoholic fatty liver disease,
typically secondary to type 2 diabetes and obesity. All of these pathways are preventable or modifiable, yet
liver cancer rates continue to rise. Furthermore, these pathways do not explain why there are observed racial
disparities in liver cancer. Past studies in breast and colorectal cancer have shown that racial residential
segregation can increase the risk for incidence and decrease survival. Segregation is believed to play a role by
increasing exposure to environmental risk factors or by limiting the socioeconomic status and health care
access of affected communities. Despite the strong racial disparities in liver cancer, previous work has not
investigated a potential link between racial segregation and liver cancer.
 The goal of this fellowship is to test the hypothesis that racial residential segregation is related to the
development of, and mortality from, hepatocellular carcinoma. This will be achieved via three aims. In Aim 1, a
novel local spatial index of segregation will be developed by using transportation data. For Aim 2, the potential
relationship between this segregation index and the mortality rate of HCC will be investigated via regression
analyses. Finally, Aim 3 will test if segregation affects an individual’s risk of developing HCC, once they
already have acquired a liver disease or hepatitis. This shall be investigated by using a retrospective cohort of
patients with liver disease or hepatitis and monitoring if and when they develop HCC. Through these three
aims, the potential relationship between segregation and HCC shall be examined at both the beginning and
end of HCC. This fellowship will result in novel methods and identify new relationships and epidemiological
patterns that can help to target future efforts to reduce the burden of HCC.

## Key facts

- **NIH application ID:** 9860917
- **Project number:** 5F30CA216947-03
- **Recipient organization:** MEDICAL COLLEGE OF WISCONSIN
- **Principal Investigator:** Amin Bemanian
- **Activity code:** F30 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $31,636
- **Award type:** 5
- **Project period:** 2018-02-01 → 2020-06-01

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9860917

## Citation

> US National Institutes of Health, RePORTER application 9860917, Investigating the Relationship Between Racial Residential Segregation and Hepatocellular Carcinoma (5F30CA216947-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9860917. Licensed CC0.

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