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Financial Burden of Liver Cancer in the United States: A Need for Policy Interventions

By: Amanda E. Ruffino, BA
Posted: Friday, March 3, 2023

Hepatocellular carcinoma is a leading cause of morbidity and mortality in patients with cirrhosis, with a growing incidence and mortality rate in the United States. In a bid to evaluate the financial implications of this trend, Amit G. Singal, MD, of The University of Texas Southwestern Medical Center, Dallas, and colleagues analyzed data from the Surveillance, Epidemiology, and End Results (SEER)-Medicare database. Published in Clinical Gastroenterology and Hepatology, their study sought to estimate the incremental costs associated with hepatocellular carcinoma in a nationally representative U.S. cohort.

“Our data highlight that hepatocellular carcinoma care not only causes considerable financial stress on the health-care system, but directly for patients and their family members, who suffer from high out-of-pocket costs. There is a clear need for policy interventions and financial support systems in this patient population,” said Dr. Singal in an institutional press release.

Results showed that patients with hepatocellular carcinoma experienced a significant increase in financial burden in the first year following diagnosis, with higher incremental patient liabilities and Medicare payments compared with those with cirrhosis alone. This financial burden was more pronounced in patients with advanced hepatocellular carcinoma, as indicated by larger tumor burden, and was significantly associated with comorbidity index, etiology, and presence of certain symptoms (such as ascites and hepatic encephalopathy).

Given the increasing incidence of hepatocellular carcinoma and the associated health-care costs, health-care policymakers should develop and implement innovative solutions to improve access to quality care and mitigate the financial burden for affected individuals, according to the authors. Ultimately, these results have important implications for medical oncologists, health-care providers, and health economists in devising strategies to improve the financial outcomes of patients with hepatocellular carcinoma.

Disclosure: For full disclosures of the study authors, visit

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