Journal of Cancer Education

, Volume 29, Issue 2, pp 214–223

Voices of Multi-ethnic Providers in NYC: Health Care for Viral Hepatitis to Prevent Hepatocellular Carcinoma

  • Hyosun Han
  • Ponni V. Perumalswami
  • Lawrence C. Kleinman
  • Lina H. Jandorf
Article

DOI: 10.1007/s13187-013-0569-7

Cite this article as:
Han, H., Perumalswami, P.V., Kleinman, L.C. et al. J Canc Educ (2014) 29: 214. doi:10.1007/s13187-013-0569-7

Abstract

Worldwide, hepatocellular carcinoma (HCC) is the third leading cause of cancer deaths and the ninth in the US. Hepatitis B and C make up almost 80 % of HCC cases. Based on our Hepatitis Outreach Network screening program data, approximately 40 % of at-risk foreign-born community members who tested positive for viral hepatitis B and/or C did not follow up for additional care. Our aim was to use theory-driven qualitative research to identify barriers and facilitators to follow-up after viral hepatitis diagnosis among these community members from the viewpoint of primary care providers (PCPs). As viral hepatitis is a precursor of liver cancer, timely treatment of the virus has the potential to reduce the incidence and burden of liver cancer. We performed semi-structured key informant interviews with 20 primary care physicians who predominantly serve Korean, Chinese, Egyptian, and Russian communities. Barriers detected included cultural factors commonly seen amongst immigrant populations such as busy work schedules and non-English language. Common facilitators include increased primary care physician involvement and linkages to care within communities in which patients reside. Providers perceived that they are gatekeepers to specialty care for their patients and therefore key persons to engage in viral hepatitis evaluation and management by specialists. This initial study suggests that re-focusing energy into primary care physicians might offer promise for improved care for individuals from immigrant communities who have viral hepatitis to help them engage in care and thereby reduce the burden of liver cancer.

Keywords

Liver cancerHepatocellular carcinomaQualitative studyHepatitis CHepatitis BBarriersFacilitatorsFollow-up

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Hyosun Han
    • 1
  • Ponni V. Perumalswami
    • 1
  • Lawrence C. Kleinman
    • 2
  • Lina H. Jandorf
    • 3
  1. 1.Division of Liver Diseases, Department of MedicineIcahn School of Medicine at Mount SinaiNew YorkUSA
  2. 2.Department of Health PolicyIcahn School of Medicine at Mount SinaiNew YorkUSA
  3. 3.Department of Oncological SciencesIcahn School of Medicine at Mount SinaiNew YorkUSA