Temporal trends and disparities in liver cancer incidence in the United States, 1999–2022: A nationwide analysis.

e16216 Background: Liver cancer remains one of the most lethal malignancies in the United States, with incidence trends that have shifted over recent decades. Characterizing long-term temporal patterns and demographic disparities is critical to understanding the evolving epidemiology of this disease. Methods: We analyzed liver cancer incidence data from 1999 to 2022 using the CDC WONDER database. Incidence rates were stratified by sex, age group, and ethnicity (Hispanic vs non-Hispanic). Joinpoint regression was used to identify temporal phases, estimate annual percent change (APC), and calculate 95% confidence intervals (CIs). Results: Liver cancer incidence over the study period demonstrated three distinct temporal phases, with patterns differing by sex and ethnicity. Phase I (1999–2010) was characterized by a significant increase in incidence across most demographic groups, with the steepest rise among non-Hispanic males (APC +6.76%), followed by non-Hispanic females (APC +3.65%). Incidence trends among Hispanic males and females did not change significantly during this period. Phase II (2011–2015) showed a deceleration in incidence growth. Non-Hispanic males experienced slowing increases, while incidence among females and Hispanic populations largely stabilized without statistically significant changes. Phase III (2016–2022) demonstrated divergent trends. Hispanic males experienced a significant decline in incidence (APC −5.23%), while non-Hispanic males showed a downward trend that did not reach statistical significance (APC −2.86%). Incidence among females remained stable across both ethnic groups. Age-stratified analyses indicated that middle-aged adults, particularly males, exhibited the most pronounced phase-specific changes, whereas younger age groups often lacked sufficient case counts for stable trend estimation. Conclusions: Over more than two decades, liver cancer incidence in the United States has followed distinct temporal phases with marked demographic disparities. Early increases, driven largely by non-Hispanic males, have slowed or reversed, while Hispanic males have experienced a significant recent decline. These findings highlight persistent disparities and emphasize the need for targeted prevention, risk factor modification, and surveillance strategies as liver cancer epidemiology continues to evolve. These trends suggest that prevention and surveillance efforts should be dynamically tailored by sex and ethnicity to sustain recent gains and address populations in which liver cancer burden remains high.