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©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
Current status of disparity in liver disease
Tomoki Sempokuya, Josh Warner, Muaataz Azawi, Akane Nogimura, Linda L Wong
Tomoki Sempokuya, Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE 68198, United States
Josh Warner, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE 68198, United States
Muaataz Azawi, Division of Gastroenterology and Hepatology, Sanford Center for Digestive Health, Sioux Falls 57105, SD, Uruguay
Akane Nogimura, Department of Public Health, Nagoya City University Graduate School of Medical Sciences, Nagoya 467-8601, Aichi, Japan
Akane Nogimura, Division of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya 467-8601, Aichi, Japan
Linda L Wong, Department of Surgery, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI 96813, United States
Author contributions: Sempokuya T, Warner J, Azawi M, Nogimura A contributed to the literature review, manuscript drafting, and editing; Wong LL contributed to study supervision, manuscript drafting, and editing; all of the authors have approved the final version of the manuscript.
Conflict-of-interest statement: Wong LL is a speaker bureau for Eisai. All other authors do not have any conflicts of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Tomoki Sempokuya, MD, Doctor, Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Nebraska Medical Center, 982000 Nebraska Medical Center, Omaha, NE 68198, United States. tsempoku@hawaii.edu
Received: September 18, 2022
Peer-review started: September 18, 2022
First decision: November 5, 2022
Revised: November 9, 2022
Accepted: November 16, 2022
Article in press: November 16, 2022
Published online: November 27, 2022
Disparities have emerged as an important issue in many aspects of healthcare in developed countries and may be based on race, ethnicity, sex, geographical location, and socioeconomic status. For liver disease specifically, these potential disparities can affect access to care and outcome in viral hepatitis, chronic liver disease, and hepatocellular carcinoma. Shortages in hepatologists and medical providers versed in liver disease may amplify these disparities by compromising early detection of liver disease, surveillance for hepatocellular carcinoma, and prompt referral to subspecialists and transplant centers. In the United States, continued efforts have been made to address some of these disparities with better education of healthcare providers, use of telehealth to enhance access to specialists, reminders in electronic medical records, and modifying organ allocation systems for liver transplantation. This review will detail the current status of disparities in liver disease and describe current efforts to minimize these disparities.
Core Tip: The liver is a uniquely complex system, the function of which can be difficult for patients to conceptualize. Given the complexity associated with managing liver disease, patients of different backgrounds can face significant disparity in care, which populations are at increased risk, and what factors cause these differences are not well understood. This review aims to summarize the disparities that exist in patients with liver disease and to bring attention to interventions that have been successful in reducing disparity among vulnerable populations.
