Date of Conferral

2021

Degree

Ph.D.

School

Public Health

Advisor

Bin Cai

Abstract

The risk of developing liver cancer among adults in the United States remains asignificant threat due to an increasing prevalence of the disease. Despite the identification of some biological, environmental, and socioeconomic risk factors, uncertainty exists as to the role of sociodemographic factors. In this study, participants (N=27,804), age 18 and over, were assessed for liver cancer outcome specific to three factors liver disease, insurance coverage, and access to healthcare. With the person-centered care model as the framework, data from the 2016 National Health and Interview Surveys were subjected to the selection criteria and quantitatively analyzed using binary logistic regression. Each predictor variable—history of liver cancer, type of health insurance coverage, and a visit to a general physician in the last 12 months—was analyzed separately, with liver cancer as the dichotomous outcome variable and age, gender, and race as the controls. The two younger age groups (26-40 and 41-65) were 96.9% (OR=0.031, 95% CI [.004, .234], p < .01) and 68.6% (OR=0.314, 95% CI [.165, .598], p < .001) less likely to develop cancer relative to the oldest (over 65) age group. Men had a 244.1% (OR=2.441, 95% CI [1.270, 4.691], p < .01) increase likelihood of liver cancer. Of the predictors tested, only a history of liver disease had a 15,506.6% (OR=155.066, 95% CI [76.123, 315.878], p < .001) increased odds of developing liver cancer. These findings address positive social change by identifying high-risk individuals to assign them to liver cancer prevention programs so those at risk can make more informed lifestyle and health care choices to mitigate liver cancer risk.

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