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General Rehabilitation

Session: Where is rehabilitation needed: Associations between county income level and the diagnosis, prognosis, and survival of Hepatocellular Carcinoma

Where is Rehabilitation Needed: Associations Between County Income Level and the Diagnosis, Prognosis, and Survival of Hepatocellular Carcinoma

Saturday, October 25, 2025
8:00 AM - 9:15 AM MT
Location: Kiosk 7
Disclosure(s):
Ojas Deshpande, MD: No financial relationships to disclose
Background and/or Objectives: Cancer rehabilitation has been proven to improve survival in patients with HCC, focusing on improvement of sarcopenia. Median county income can be used as a tool to find areas with increased barriers to care, often rural areas or disadvantaged urban areas. To determine rehabilitation needs for hepatocellular carcinoma (HCC) patients based on community income level, using diagnosis, staging, and survival measures.

Design: Retrospective cohort

Setting : National cancer database

Participants : US adults 18 years and older with HCC using data from the 2015 to 2019 in the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) registry.

Interventions: not applicable

Main Outcome Measures: We looked at survival, measured at every year for 5 years. Median county household income level was recorded as under $50K, between $50K and $65K, and over $65K. HCC tumor stage was evaluated using SEER staging system. Age at diagnosis was recorded as under 45, 45-54 years old, 55-64 years old, 65-74 years old, and 75+ years old.

Results: 159,832 HCC patients (11.92% under $50K, 29.67% between $50K and $65K, and 58.41% over $65K) were assessed. Patients from counties with income levels under $50K were significantly less likely to have localized tumor stage at time of diagnosis compared with patients from communities with higher income levels (p < 0.001). Patients diagnosed at age 45-64 were disproportionately from counties with lower median income. (p < 0.001). Patients from lower income counties (Haz ratio 1.07 vs 1.02, p< 0.001) had significantly lower survival compared with higher income county patients.

Conclusions: Among US adults with HCC, community income level significantly affects tumor stage at diagnosis, age at diagnosis, and overall survival. Patients from communities with lower income levels had more advanced tumor stage at diagnosis, were younger at diagnosis, and had lower overall survival. This highlights the need for rehabilitation in those areas and increased access to cancer rehabilitation.