Bringing Liver Cancer Prevention to Your Door

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Hepatocellular carcinoma, or liver cancer, is the fastest growing cancer in the United States, with a large portion of its cases due to chronic infections of viral hepatitis B or C (HBV; HCV).1 Liver cancer is highly fatal, but prevention is possible with HBV and HCV risk reduction, including HBV vaccination and antiviral treatments.2 

Additionally, individuals with experiences of homelessness (IEH) are much more likely to contract viral hepatitis than members of the general population, with some studies finding prevalence rates as high as 47-86%.3,4 Individuals with experiences of homelessness are also historically disproportionately impacted by HBV/HCV- throughout the hepatitis continuum of care, meaning while being burdened with a high prevalence of these diseases, they are unable to effectively receive testing, vaccination, or treatment.5  

The movement towards a permanent supportive housing (PSH) model provides a new opportunity to engage IEH, and the point at which GRASSROOTS HEALTH hopes to engage IEH.  

GRASSROOTS HEALTH is a cross-sector collaboration between a healthcare for the homeless clinic, academic institution, and permanent supportive housing (PSH) provider. 

Our Main Goal: To enhance health equity by bringing HBV/HCV education, testing, HBV vaccination and HBV/HCV treatment directly to the door of PSH residents. 


  1. Cronin, K.A., Lake, A.J., Scott, S., Sherman, R.L., Noone, A.-M., Howlader, N., Henley, S.J., Anderson, R.N., Firth, A.U., Ma, J., Kohler, B.A. and Jemal, A. (2018), Annual Report to the Nation on the Status of Cancer, part I: National cancer statistics. Cancer, 124: 2785-2800. https://doi.org/10.1002/cncr.31551
  2. Villanueva A. (2015). Acute-on-chronic liver failure: pathophysiology, prognostication, and treatment. Hepatology, 62:165-174. 
  3. Hofmeister, Megan G.1,2; Rosenthal, Elizabeth M.3; Barker, Laurie K.1; Rosenberg, Eli S.3; Barranco, Meredith A.3; Hall, Eric W.4; Edlin, Brian R.5; Mermin, Jonathan5; Ward, John W.1,6; Ryerson, A. Blythe1. Estimating Prevalence of Hepatitis C Virus Infection in the United States, 2013?2016. Hepatology 69(3):p 1020-1031, March 2019. | DOI: 10.1002/hep.30297
  4. Page, K., Yu, M., Cohen, J. et al. HCV screening in a cohort of HIV infected and uninfected homeless and marginally housed women in San Francisco, California. BMC Public Health 17, 171 (2017). https://doi.org/10.1186/s12889-017-4102-5
  5. Stein, J. A., Andersen, R. M., Robertson, M., & Gelberg, L. (2012). Impact of hepatitis B and C infection on health services utilization in homeless adults: A test of the Gelberg-Andersen behavioral model for vulnerable populations. Health Psychology, 31(1), 20–30.

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Thank you to CPRIT for generously funding this work. Grant ID: PP220022. Liver Cancer Prevention Among Those with Experiences of Homelessness: An Expansion to Low-Income Housing in South Texas. PI: Vanessa Schick, PhD (Houston); Jack Tsai, PhD (San Antonio)