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Healthcare
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Healthcare Disparities in Screening, Detection and Treatment of Cancer
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Healthcare Disparities in Screening, Detection and Treatment of Cancer

A special issue of Healthcare (ISSN 2227-9032).

Deadline for manuscript submissions: 31 August 2026 | Viewed by 2986

Special Issue Editors

Dr. Clara Benna

E-Mail Website
Guest Editor
Department of Surgery, Oncology and Gastroenterology (DISCOG), University of Padova, 35124 Padova, Italy
Interests: meta-analysis; epidemiology; migrants’ health
Dr. Silvia Negro

E-Mail Website
Guest Editor
Department of Surgery, Oncology and Gastroenterology (DiSCOG), University of Padua, Via Giustiniani 2, 35128 Padua, Italy
Interests: gender medicine; precision medicine; oncologic surgery; hereditary gastrointestinal disease; colorectal cancer; lynch syndrome; molecular profiling
Dr. Giulia Becherucci

E-Mail Website
Guest Editor
Department of Surgery—ULSS1 Dolomiti, Ospedale San Martino, 32100 Belluno, Italy
Interests: colorectal cancer; tumor microenvironment; oncologic surgery; gender medicine; gender inequality in surgery
Dr. Giulia Capelli

E-Mail Website
Guest Editor
Department of Surgery, ASST Bergamo Est, 24068 Seriate, Italy
Interests: oncologic outcomes; surgical oncology; gastric cancer; colorectal cancer; gender medicine; gender gap and equity in surgery; artificial intelligence surgery

Special Issue Information

Dear Colleagues,

Healthcare disparities are differences in health outcomes and access to healthcare services among different population groups. Disparities in cancer care lead to unequal health repercussions and exacerbate existing social inequalities in modern society. These disparities can occur across various dimensions, including race, ethnicity, socioeconomic status, gender, geography, and education, and have profound consequences for individuals and communities.

We are pleased to invite you to contribute to a Special Issue titled “Healthcare Disparities in Screening, Detection and Treatment of Cancer”.

This Special Issue aims to explore the critical challenges and inequities faced by diverse populations in cancer care, from early screening to treatment outcomes.

In this Special Issue, original research articles and reviews are welcome. Research areas may include (but are not limited to) the following:

  • Disparities in access to cancer screening and early detection and health consequences;
  • Socioeconomic, racial, and geographic barriers to cancer care and implications for healthcare delivery;
  • Innovative interventions and policy solutions to reduce cancer disparities and improve healthcare services;
  • Gender disparities in cancer therapy benefits.

We look forward to receiving your contributions. 

Dr. Clara Benna
Dr. Silvia Negro
Dr. Giulia Becherucci
Dr. Giulia Capelli
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • health inequities
  • access to care
  • cancer prevention
  • early detection
  • socioeconomic barriers

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (2 papers)

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Research

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14 pages, 1157 KB  
Article
Sex-Specific Associations of Total Bilirubin, ALBI, and PALBI with Lung Cancer Risk: Interactions with Smoking and Alcohol
by Jong Won Shin, Nguyen Thien Minh and Sun Ha Jee
Healthcare 2025, 13(11), 1321; https://doi.org/10.3390/healthcare13111321 - 2 Jun 2025
Cited by 9 | Viewed by 1767
Abstract
Background: Bilirubin is a potent endogenous antioxidant that plays a key role in regulating oxidative stress and inflammation, both closely linked to lung carcinogenesis. This study reinterprets the ALBI (Albumin–Bilirubin) and PALBI (Platelet–Albumin–Bilirubin) indices as composite markers of antioxidant and inflammatory status and [...] Read more.
Background: Bilirubin is a potent endogenous antioxidant that plays a key role in regulating oxidative stress and inflammation, both closely linked to lung carcinogenesis. This study reinterprets the ALBI (Albumin–Bilirubin) and PALBI (Platelet–Albumin–Bilirubin) indices as composite markers of antioxidant and inflammatory status and evaluates their associations with lung cancer risk by sex, including stratified analyses by major lifestyle factors such as smoking and alcohol use. Methods: This study utilized data from the Korean Cancer Prevention Study-II (KCPS-II) cohort, which included 133,630 participants. During a mean follow-up of 13.5 years, 721 incident lung cancer cases were identified. Serum bilirubin and the ALBI and PALBI indices were analyzed by sex, and quartile-based and trend analyses were conducted. Stratified analyses by smoking and alcohol status (never, former, current, ever) and intensity were performed to assess potential effect modification. Cox proportional hazards regression models were used to estimate HRs and 95% CIs. Results: A 1SD increase in total bilirubin and ALBI was inversely associated with lung cancer risk in men (HR: 0.83, 95% CI: 0.75–0.91; HR: 0.86, 95% CI: 0.79–0.94, respectively), whereas PALBI showed a positive association (HR: 1.17, 95% CI: 1.07–1.28). In contrast, in women, total bilirubin and ALBI showed positive associations (HR: 1.19, 95% CI: 1.00–1.40; HR: 1.19, 95% CI: 1.02–1.40, respectively), while PALBI was inversely associated (HR: 0.82, 95% CI: 0.69–0.97). These associations were significant among men who were smokers (former, current, ever) and men who drank alcohol (current, ever), whereas in women, significance was observed only among never drinkers. Stronger interactions were observed in men who were heavy smokers and low-to-moderate drinkers. Conclusions: Bilirubin and the ALBI and PALBI indices exhibit sex-specific and contrasting associations with lung cancer risk, highlighting the need to consider sex-based physiological differences in cancer risk assessment. Full article
(This article belongs to the Special Issue Healthcare Disparities in Screening, Detection and Treatment of Cancer)
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Review

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17 pages, 611 KB  
Review
Hepatocellular Carcinoma in Southeast Asian Americans: Epidemiologic Trends, Screening Challenges, and Policy Implications
by Ahauve M. Orusa, Abby M. Lohr, Khalid F. Abu-Zeinah, Irene G. Sia, Jennifer L. Ridgeway, Aminah Jatoi and Nguyen H. Tran
Healthcare 2026, 14(10), 1314; https://doi.org/10.3390/healthcare14101314 - 12 May 2026
Viewed by 357
Abstract
Background: Southeast Asian Americans (SEAAs) experience a disproportionately high burden of hepatocellular carcinoma (HCC), with incidence in several subgroups (i.e., Cambodian, Laotian, and Vietnamese individuals) reaching up to nine times that of non-Hispanic Whites. HCC in SEAAs is largely driven by chronic [...] Read more.
Background: Southeast Asian Americans (SEAAs) experience a disproportionately high burden of hepatocellular carcinoma (HCC), with incidence in several subgroups (i.e., Cambodian, Laotian, and Vietnamese individuals) reaching up to nine times that of non-Hispanic Whites. HCC in SEAAs is largely driven by chronic hepatitis B (HBV), hepatitis C (HCV), metabolic dysfunction–associated steatotic liver disease (MASLD), and alcohol-associated liver disease (ALD). Despite established screening guidelines, under-detection and delayed diagnosis remain common. Objective: To summarize epidemiologic patterns, risk factors, screening challenges, and potential interventions aimed at reducing HCC disparities among SEAAs. Design and Methods: This narrative review synthesized evidence from population based epidemiologic studies, community-based interventions, health services research, and policy analyses. Attention was given to studies reporting disaggregated SEAA subgroup data. Findings derived from SEAA specific studies were distinguished from evidence drawn from broader Asian American or general cirrhosis populations, with inferential steps explicitly noted where subgroup specific data were limited. Key Findings: HCC incidence varies widely across SEAA subgroups, with elevated HBV- and HCV-related HCC in Vietnamese, Cambodian, and Laotian communities, and increasing MASLD-related HCC including among lean individuals who fall outside many surveillance frameworks. Screening and surveillance remain suboptimal, with fewer than 30% of patients with cirrhosis receiving recommended semiannual HCC surveillance and even lower uptake among SEAAs. Barriers include low HBV/HCV screening rates, limited disease awareness, language barriers, underinsurance, provider knowledge gaps, and lack of automated EHR-based reminders. Structural challenges such as poverty, transportation barriers, and limited access to specialty care further delay diagnosis. Proposed Interventions: Culturally tailored outreach programs, bilingual navigators, and community-based screening initiatives have demonstrated improved HBV/HCV testing and linkage to care. AI-enabled EHR tools may enhance identification of high-risk patients, streamline follow-up, and increase surveillance adherence. Expanded use of non-invasive fibrosis assessment and recognition of MASLD-related risk in non-obese individuals may support earlier detection. Policy priorities include mandatory Asian subgroup data disaggregation, expanded insurance coverage, and strengthened community-level healthcare infrastructure. Conclusions: SEAAs face a substantial and preventable HCC burden. A coordinated approach combining culturally tailored community engagement, improved provider support systems, and policy reforms is essential to improving early detection and reducing HCC disparities in this diverse population. Full article
(This article belongs to the Special Issue Healthcare Disparities in Screening, Detection and Treatment of Cancer)
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