A Summary of the HCC-CARE Symposium: Collaborative Approaches to Reaching Equity in Hepatocellular Carcinoma in Boston by 2030

Abstract

Hepatocellular carcinoma (HCC) is a leading cause of cancer mortality in the United States. Disparities in HCC incidence and mortality are amplified in Boston, Massachusetts, which has 42% higher HCC mortality than the nation. HCC-CARE was a one-day symposium that aimed to identify goals and strategies necessary to eliminate HCC disparities in the Greater Boston area by 2030. Sixty-six local and state stakeholders attended the symposium, including HCC clinical experts (eg, medical oncologists) and primary care clinicians representing all seven of Boston's major cancer centers, ancillary staff members (eg, social workers) and state and local government agencies. The symposium included introductory sessions on HCC disparities, conceptual approaches to addressing disparities, and perspectives of local stakeholders on HCC disparities, followed by two interactive workshops where nine groups brainstormed and voted on goals, then developed preliminary action plans. Symposium participants identified four priority goals and developed associated action plans to eliminate HCC disparities by 2030: 1) improving HCC screening rates to enable early detection, 2) employing community engagement and outreach to communities at high risk of HCC, 3) developing a multi-institutional HCC registry to inform care delivery improvements, and 4) connecting patients with HCC to support services to address common barriers to care. A fifth priority around addressing disparities in HCC treatment emerged from post-symposium feedback. HCC-CARE established a knowledge base and raised the saliency of HCC disparities among participants, created a multi-institutional consortium of individuals committed to addressing HCC disparities, and leveraged the wide-ranging expertise of the participants to identify key goals and strategies for achieving equity in HCC outcomes by 2030. These strategies require further development and implementation through multi-institutional committees established after the symposium for each priority area. The Symposium represented a key first step in launching coordinated efforts to reduce HCC disparities that other cities may emulate.

Keywords: health equity; hepatocellular carcinoma.

Figure 1

Goals and voting patterns. On the left, goals are listed in order of highest vote total and converge into themes in the center. See Supplemental Table 1 for a description of each goal. On the right, votes by role group converge into the themes in the center.