Rising Hepatocellular Carcinoma Incidence and Mortality in the United States: A Comprehensive Analysis

Background and purpose

Over the past two decades, the incidence of primary liver cancer has increased significantly in the United States, with a higher prevalence observed in men. The burden increases with age and particularly affects men, whose mortality rate is three times that of women. The higher incidence in men may be partially due to the higher prevalence of risk factors such as alcohol abuse and chronic HBV and HCV infection. A recent study of the Surveillance Epidemiology and End Results (SEER) database showed that liver cancer incidence and mortality rates in the United States increased from 1975 to 2017. The most significant increase in incidence was observed in men and older adults. Another study found that HCC mortality rates have changed among different age groups in recent years. It was found that mortality rates were decreasing among young people but increasing among older people. Additionally, trends in liver cancer among racial groups showed an increase in incidence and mortality from 1975 to 2017, with variation across racial groups.

Given the observed increases in the incidence and mortality of HCC, as well as disparities between age and racial/ethnic groups, analysis of recent trends is critical to identifying high-risk populations, early detection, It helps guide interventions, treatments, and ultimately improve patient outcomes. Although current literature provides insight into the increasing incidence and mortality of HCC, data on recent sex-, age-, racial/ethnic group-specific incidence and mortality, and time trends remain lacking. Limited. This is particularly important given the increasing incidence of some gastrointestinal cancers in young adults, especially young women. Therefore, this study aimed to assess the recent incidence and mortality of her-HCC in the United States, as well as temporal trends, with a focus on specific gender, age, and race/ethnicity.

method

Age-adjusted HCC incidence rates were calculated from the Centers for Disease Control’s National Cancer Statistics database. This database combines incidence data for newly diagnosed cancer cases and covers approximately 98% of the U.S. population. Additionally, age-adjusted HCC mortality rates were obtained from the Centers for Disease Control and Prevention’s National Health Statistics Database. This database provides comprehensive coverage of nearly 100% of HCC deaths in the United States. Proportions were stratified by gender and age (elderly). [≥55 years] and young [<55 years] adult), race and ethnicity (non-Hispanic white, non-Hispanic black, Hispanic, non-Hispanic Asian/Pacific Islander, non-Hispanic American Indian/Alaska Native), tumor stage at diagnosis (early and late ). Annual and average annual percentage change (AAPC) were calculated using joinpoint regression. Gender-specific pairwise comparisons were conducted.

result

Between 2001 and 2020, the number of patients diagnosed with HCC was 467,346 (26.0% women), and the incidence increased in both men and women without significant difference (p=0.65). In young adults (78,169 patients), the incidence was reduced in men but not in women (AAPC difference = -2.39, p=0.002). This was seen in different racial and ethnic groups and was primarily driven by early-stage tumors (AAPC difference = -2.65, p = 0.02). Between 2000 and 2020, there were 329,973 deaths from hepatocellular carcinoma (28.4% women). Among young adults (43,093 deaths), there was a greater reduction in mortality among men than among women (AAPC difference=1.61, p=0.007). This was seen across a variety of racial and ethnic groups, particularly among non-Hispanic American Indian/Alaska Natives (AAPC difference = −4.51, p = 0.01).

conclusion

In conclusion, a comprehensive nationwide analysis of the USCS database, which covers nearly all patients diagnosed with HCC, shows that the incidence of HCC has increased between 2001 and 2020 . Our analysis of young adults shows a decrease in her HCC incidence in young men but not in women. This trend was seen in different racial/ethnic groups and was primarily driven by tumors diagnosed earlier. Additionally, an evaluation of the NCHS database, which covers nearly all deaths from HCC in the United States, showed that HCC mortality rates increased from 2000 to 2020. When evaluating young adults, we found that hepatocellular carcinoma mortality rates improved at a higher rate in men than in men. This was evident across different racial/ethnic groups, especially Nairn. Reasons for differences in morbidity and mortality between men and women are unknown, and known and undiscovered modifiable and unmodifiable risk factors may disproportionately affect young women This is thought to be due to. Future research is needed to identify risk factors associated with HCC occurrence and outcome in different populations, especially young women.