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. 2014 Apr;109(4):542-53.
doi: 10.1038/ajg.2014.11. Epub 2014 Feb 11.

Changing hepatocellular carcinoma incidence and liver cancer mortality rates in the United States

Sean F Altekruse  1 , S Jane Henley  2 , James E Cucinelli  3 , Katherine A McGlynn  4
Affiliations

Changing hepatocellular carcinoma incidence and liver cancer mortality rates in the United States

Sean F Altekruse et al. Am J Gastroenterol. 2014 Apr.

Abstract

Objectives: The objectives were to describe Surveillance, Epidemiology and End Results (SEER) hepatocellular carcinoma (HCC) incidence trends and the US liver cancer mortality trends by geography, age, race/ethnicity, and gender.

Methods: HCC incidence data from SEER 18 registries and liver cancer mortality data from the National Center for Health Statistics were analyzed. Rates and joinpoint trends were calculated by demographic subgroup. State-level liver cancer mortality rates and trends were mapped.

Results: HCC incidence rates in SEER registries did not significantly increase during 2007-2010; however, the US liver cancer mortality rates did increase. HCC incidence and liver cancer mortality rates increased among black, Hispanic, and white men aged 50+ years and decreased among 35-49-year-old men in all racial/ethnic groups including Asians/Pacific Islanders. Significantly increasing incidence and mortality rates among women were restricted to blacks, Hispanics, and whites aged 50+ years. Asian/Pacific Islander liver cancer mortality rates decreased during 2000-2010 with decreasing rates among women aged 50-64 years and men aged 35-49 years and stable rates in other groups. During 2006-2010, among individuals 50-64 years of age, blacks and Hispanics had higher incidence and mortality rates than Asians/Pacific Islanders. Liver cancer mortality rates were highest in Louisiana, Mississippi, Texas, and Washington, DC.

Conclusions: Decreasing HCC incidence and liver cancer mortality rates among Asians/Pacific Islanders, men aged 35-49 years, and the nonsignificant increase in overall HCC incidence rates suggest that the peak of the epidemic may be near or have passed. Findings of geographic variation in mortality rates can inform control efforts.

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Conflict of interest statement

Conflicts of interest: The authors report no conflicts of interest.

Figures

Figure 1
Figure 1
Age-adjusted SEER 18 HCC incidence and U.S. liver cancer mortality rates by age group and year; 2000–2010 CI=confidence interval Trend = annual percent change, or APC. Joinpoint regression defines when a trend changes. Up to one joinpoint allowed in the eleven year period. * Asterisk indicates slope of trend differs from zero (P<0.05)
Figure 2
Figure 2
Age-adjusted HCC incidence rates per 100,000 by age group, gender, non-Hispanic race and Hispanic ethnicity, SEER 18 registries -- 2000–2010
Figure 3
Figure 3
Age-adjusted liver cancer mortality rates per 100,000 by age group, gender, non-Hispanic race and Hispanic ethnicity, United States -- 2000–2010
Figure 4
Figure 4
Age-adjusted liver cancer mortality rates per 100,000 by state, 2006–2010
Figure 5
Figure 5
Annual percent change (APC) in liver cancer mortality rates by state, 2000 to 2010 by age group: (A) 35 to 49, (B) 50 to 64 and (C) 65+ years of age
See this image and copyright information in PMC

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