Epidemiology and sociodemographic trends of hepatocellular carcinoma in Nevada: A decade-long statewide analysis.

483 Background: Hepatocellular carcinoma (HCC) incidence is rising nationwide, but state specific trends for Nevada remain underexplored. Nevada’s geographic diversity, racially heterogenous population, and distinct occupational landscape make it an important setting to explore how sociodemographic and regional factors impact HCC outcomes. Prior studies, including those from the Texas Hepatocellular Carcinoma Consortium, have demonstrated disparities by demographics and geography, emphasizing the need for localized data to guide interventions. Methods: We conducted a retrospective analysis of n=1,911 HCC cases reported to the Nevada Central Cancer Registry from 2009 to 2019. Variables included age, sex, race/ethnicity, occupation, insurance type, and geographic classification (urban, rural, frontier). Trends in incidence and overall survival were assessed using descriptive statistics and non-parametric tests. Results: HCC incidence increased from 2009 to 2019; however, survival times remained stable. Most patients were male (74%) and resided in urban areas (85%). The largest racial/ethnic group was White (61.3%), followed by Hispanic (14.0%), Asian (12.6%), Black (9.9%), and Native American (1.9%). Individuals employed in manual labor, skilled traded, and similar sectors comprised the largest occupational group (38.4%). Frontier and rural residents together represented 14.3% of cases. Public insurance was the most common coverage type (54%), followed by private insurance (24.1%), and uninsured (4.4%). Median age at diagnosis was 64.9 years. Survival outcomes showed no significant differences by race/ethnicity (p=0.46) or geographical classification (p=0.43); descriptively, the lowest survival group in days was Native American individuals (108 days), with Black individuals (132 days), White individuals (167 days), Hispanic (169 days), and Asian individuals (193.5 days) having higher survival. Frontier residents had the shortest median survival (115 days) followed by urban (168 days) and rural (196 days). Conclusions: This is the first comprehensive analysis of HCC in Nevada. While statistical significance was not reached for race or geographic survival differences, Native American patients and frontier residents had the shortest survival times, suggesting disparities. These findings underscore the importance of ongoing state-level cancer surveillance and region-specific strategies to reduce inequities and improve HCC outcomes.