What question did this study set out to answer?

To evaluate long-term trends in HCC incidence rates and incidence rate ratios (IRRs) by sex and race/ethnicity in the U.S. across three decades.

April 5, 2026

Abstract 3572: Narrowing of sex and racial/ethnic ratios for hepatocellular carcinoma incidence in the United States, 1992 - 2022

Key Result

Hepatocellular carcinoma incidence disparities narrowed from 1992 to 2022, with the Asian/Pacific Islander-to-White ratio dropping from 5.8 to 1.9 and the Black-to-White ratio from 2.0 to 1.4.

Key Points

To evaluate long-term trends in HCC incidence rates and incidence rate ratios (IRRs) by sex and race/ethnicity in the U.S. across three decades.
Analyzed HCC cases from SEER data (1992-2022)
Calculated age-adjusted incidence rates per 100,000
Estimated sex ratios using women as reference group and racial ratios using non-Hispanic Whites as reference
Applied Joinpoint regression to evaluate temporal trends in incidence rates
Total of 68,023 HCC cases identified with an increase in cases from 840 in 1992 to 2,846 in 2022
Age-adjusted incidence rose from 4.27 to 7.84 per 100,000
Decline in male-to-female IRR from 3.29 to 3.11 after 2012
HCC incidence was highest in NH Asian or Pacific Islanders, followed by Hispanics and NH Blacks
IRR narrowing observed across groups, particularly for NHAPI and NHB relative to NHW

Structured PICO

Population

68,023 hepatocellular carcinoma (HCC) cases diagnosed from 1992 to 2022 in the SEER 12 registry.

Outcome

Age-adjusted incidence rates and incidence rate ratios (IRRs) over time

HCC incidence in the US has declined since 2015, accompanied by a narrowing of sex and racial/ethnic incidence disparities over the past three decades.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Abstract Background: Temporal trends in hepatocellular carcinoma (HCC) incidence in the U.S. have not been uniform across all adult populations. Most national analyses have focused on absolute rates within demographic groups rather than changes in incidence rate ratios (IRRs) over time. Because IRRs directly quantify relative disparities, evaluating their temporal trends can clarify how sex- and race/ethnicity-specific differences are evolving. We examined long-term trends in HCC incidence and IRRs using three decades of SEER data. Methods: We analyzed HCC cases diagnosed from 1992 to 2022 in the SEER 12 registry. Age-adjusted incidence rates (per 100,000; 2000 U.S. standard) were calculated overall and by sex, race/ethnicity, and age group (50 vs ≥50 years). Sex ratios were estimated with women as the reference group, while race/ethnicity ratios were estimated with non-Hispanic White (NHW) individuals as the reference group. Temporal trends were evaluated using Joinpoint regression to estimate annual percent change (APC) and average APC (AAPC) with 95% confidence intervals (CIs). Results: 68,023 total HCC cases were identified. Annual cases increased from 840 in 1992 to 2,846 in 2022. Age-adjusted incidence rose from 4.27 to 7.84 per 100,000 (AAPC, 2.03%). Incidence increased during 1992-2009 (APC, 4.72%), was stable from 2009-2015, and declined during 2015-2022 (APC, 3.41%). Incidence remained higher in men, increasing from 6.97 to 12.24 per 100,000 (AAPC, 2.38%), compared with 2.13 to 3.95 per 100,000 in women (AAPC, 2.45%). However, the male-to-female IRR declined from 3.29 to 3.11, with an inflection in 2012; the IRR increased before 2012 (APC, 0.51%) and decreased thereafter (APC, -1.64%). Across racial/ethnic groups, incidence was highest among NH Asian or Pacific Islander (NHAPI) (14.27 per 100,000), followed by Hispanic (12.12), NH Black (NHB) (9.30), and NHW (4.37). AAPCs were highest for NHW (3.12%) and Hispanic (2.54%), intermediate for NHB (2.37%), and negative for NHAPI (-0.93%). Segment-specific APCs differed by group: NHW rates increased during 1992-2013 and declined thereafter; NHB and Hispanic rates increased during early periods and declined or stabilized in later years; NHAPI incidence increased modestly until 2007 and decreased thereafter. Similarly, the NHAPI:NHW IRR declined from 5.8 to 1.9 (AAPC, -3.93%); the NHB:NHW IRR declined from 2.0 to 1.4 (AAPC, -0.73%); and the Hispanic:NHW IRR decreased slightly from 2.7 to 2.4 (AAPC, -0.57%). Conclusion: HCC incidence increased through the early 2010s but has declined since 2015. Sex- and race/ethnicity-specific IRRs narrowed across the study period, driven by declining rates among NHAPI and NHB populations and slower increases among Hispanic individuals relative to NHW. These 30-year trends demonstrate substantial shifts in the demographic distribution of HCC incidence in the U.S. and may reflect changes in etiology. Citation Format: Samantha Sarlin, Aaron P. Thrift, Hyeyeun Lim, . Narrowing of sex and racial/ethnic ratios for hepatocellular carcinoma incidence in the United States, 1992 - 2022 abstract. In: Proceedings of the American Association for Cancer Research Annual Meeting 2026; Part 1 (Regular Abstracts); 2026 Apr 17-22; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2026;86(7 Suppl):Abstract nr 3572.

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