Mapping preventable risks: Obesity, alcohol, and hepatocellular carcinoma in the U.S.

528 Background: Hepatocellular carcinoma (HCC) is a major public health concern in the U.S., with obesity and alcohol consumption as key modifiable drivers. Geographic variation in these risk factors and cancer burden may influence clinical outcomes, which remain poorly defined. An understanding of regional and state-level disparities is essential for prevention, risk assessment, and equitable policy. Methods: We analyzed Behavioral Risk Factor Surveillance System (BRFSS) and CDC WONDER data to assess obesity, excessive alcohol use (EAU), and HCC across U.S. regions and states from 2018 to 2022. EAU was defined as heavy drinking (≥15 drinks/week men, ≥8 women) or binge drinking (≥5 drinks/occasion men, ≥4 women). Obesity was BMI ≥30. Outcomes included prevalence of obesity, EAU, and self-reported HCC (BRFSS), and age-adjusted HCC incidence (CDC WONDER). Weighted prevalence was estimated using BRFSS survey design, and logistic regression models generated adjusted odds ratios (aORs) controlling for age, sex, race/ethnicity, income, insurance, and primary care physician (PCP) visit. Stata software was used for analysis and p