Background: Liver and Bile Duct Cancer is a significant public health concern with higher incidence rates observed among people belonging to racial and ethnic minority groups compared to non-Hispanic White people. This study aims to understand which underlying factors contribute most to this disparity in liver and bile duct cancer. Methods: The California Health Maps database was analyzed from 2015-2019, including 58 counties: consistent with the SEER census and CDC PLACES Project. Variables examined included race, ethnicity, age, health insurance status, foreign-born status, rural residence, obesity prevalence, socioeconomic status, smoking status, and percentage of individuals receiving preventative care. Linear regression analysis was used to determine which factors significantly predict higher prevalence of liver and bile duct cancer. Results: The population consisted of 39,283,494 people, predominantly Hispanic (39%) with 38.7% being non-Hispanic White; 15.5% Asian or Pacific Islander and 6.2% non-Hispanic Black. Hispanic people accounted for 21% of the 868,882 total cancer cases and 33% of the 22,439 cases of liver and bile duct cancers reported. Race and ethnicity were the most substantial predictors of liver and bile duct cancer prevalence; counties with a higher monitory population exhibited higher incidence rates (Hispanic: R=0.39; p=0.003, Black: R=0.39; p=0.004, White: R=-0.55; p<0.0001, Asian: R=0.33; p=0.01). Being foreign-born (R=0.45; p=0.0008), residing in non-rural areas (R= -0.33; p=0.01), and lacking preventative care (women: R= -0.30; p=0.03, men: R= -0.37; p=0.006) were also significantly associated with increased liver and bile duct cancer incidence rates (Table). Conclusions: This study highlights the association of race, ethnicity, and access to healthcare services with higher incidence rates of liver and bile duct cancer among Hispanic and non-Hispanic Black people compared to non-Hispanic White people. Addressing these disparities is crucial for promoting equitable health outcomes in liver and bile duct cancer.

Data from 58 counties, R, and p-value for each risk factor’s ability to predict liver and bile duct cancer incidence rate. Significant correlations are in bold.