Hepatocellular Carcinoma Incidence is Decreasing Among Younger Adults in the United States

Abstract

BACKGROUND & AIMS: 

Incidence rates for hepatocellular carcinoma (HCC) increased rapidly in the United States (US) since the 1990s, but have plateaued or started to decrease in other industrialized countries. It unclear if and when a similar trend will be observed in the US. We examined trends in HCC incidence rates in the US by age, sex, and race/ethnicity of patients.

METHODS: 

We calculated age-adjusted HCC incidence rates using data from the Surveillance, Epidemiology, and End Results program of cancer registries from 1992 through 2015. We estimated incidence rates by 10-year age group and used joinpoint regression to quantify the magnitude and direction of trends, overall and by sex and race/ethnicity (non-Hispanic white, non-Hispanic black, Hispanic, and Asian/Pacific Islander).

RESULTS: 

HCC incidence increased by 4.8% per year from 1992 through 2010 (from 4.1 per 100,000 to 9.4 per 100,000) but then started to plateau (annual percent change, -0.7; 95% CI, -2.0 to 0.7). Incidence rates steadily increased among persons 60 years or older in all racial/ethnic groups except Asian/Pacific Islanders 70-79 years old. In contrast, incidence rates decreased in younger and middle-aged adults, in men and women of all races/ethnicities, beginning in the mid-2000s. Rates decreased by 6.2% per year in persons 40-49 years old and by 10.3% per year in persons 50-59 years old. Annual decreases in incidence were larger among middle-aged blacks (17.2% decrease per year since 2012) compared to adults of the same age in other racial/ethnic groups.

CONCLUSIONS: 

In an analysis of data from the Surveillance, Epidemiology, and End Results program of cancer registries from 1992 through 2015, we found the incidence of HCC to be decreasing among younger and middle-aged adults in the US, regardless of sex or race or ethnicity. It is unclear whether current decreases in incidence will reduce the burden of HCC in the future.

Authors

Rich NE1, Yopp AC2, Singal AG3, Murphy CC4. Clin Gastroenterol Hepatol. 2019 Apr 28. pii: S1542-3565(19)30433-1. doi: 10.1016/j.cgh.2019.04.043. [Epub ahead of print]

Author Information

1.  Department of Internal Medicine.

2.  Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX; Harold C. Simmons Comprehensive Cancer Center, Dallas, TX.

3.  Department of Internal Medicine; Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX; Harold C. Simmons Comprehensive Cancer Center, Dallas, TX.

4.  Department of Internal Medicine; Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX; Harold C. Simmons Comprehensive Cancer Center, Dallas, TX. Electronic address: caitlin.murphy@utsouthwestern.edu.

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