Purpose and General Information

What is the STRIVE Study?

The Southern Liver Health Study (STRIVE) began in September 2021. The purpose of the study is to learn about what factors make someone more or less likely to get liver diseases or liver cancer. The STRIVE study will be the first large-scale and long-term study to learn more about this with specific goals to study a diverse population to benefit those most impacted by some of the factors.

Environmental Factors:

Some of the factors we are looking at are environmental. We want to see how environmental contaminants, like toxic metals, such as cadmium, and per- and poly-fluoroalkyl substances (PFAS), impact liver health and the risk of developing HCC (liver cancer) and liver disease. These contaminants are common. Cadmium is ranked in the top ten chemicals of concern by the World Health Organization and can cause cancer in animals. 

STRIVE will also expand our understanding of the health impacts from long-term exposure to PFAS. These are a class of chemicals that have become very common in our environment because of their widespread use and how they do not break down easily, giving them the nickname “forever chemicals.”

Other Factors:

The other factors we are also looking into are social, economic, geographic, lifestyle, diet, and epigenetic. This will help us study why liver cancer is more greatly impacting minorities and rural communities.

Liver Cancer: 

Specifically, we are looking into why some people are more at risk than others of progressing from healthy to having liver disease, or from having liver disease to hepatocellular carcinoma (HCC), the most common type of liver cancer.

Hepatocellular carcinoma (HCC) is one of few growing cancers that affects ethnic minorities and rural residents more. We know some risk factors to this cancer are viral hepatitis, fatty liver disease and cirrhosis. However, these factors do not fully explain these health disparities. Although we don’t know what is causing this, it is one reason why we want to study this topic. We want to make sure our research will benefit the populations most impacted by liver disease and liver cancer. These are often the same groups who have been most historically marginalized when it comes to their health and who experience adverse impacts from their environment. 

The Future:

The long-term goal for this research is to help communities and researchers understand how to prevent, detect and diagnose liver disease and liver cancer and understand what factors increase your risk for these conditions. Liver disease is becoming more common, especially for African-Americans and other minorities who have historically been excluded in research efforts. Our goal is to carry out research with participants who reflect the diverse communities across North Carolina and Georgia, so that those who are most impacted from this disease more greatly benefit from the outcomes. We hope to use what we learn to develop early intervention / detection efforts and impact future decisions.