Incidence of primary liver cancer by Scottish cancer networks, 2000–2023: A population-based cancer registry study of 11,933 cases

INTRODUCTION: Primary liver cancer (PLC) remains a significant global health challenge with rising incidence rates and poor prognosis. While Scotland has historically faced high disease burdens, recent data indicate that PLC incidence has transitioned from a period of rapid growth to a stabilised plateau since 2014. PLC risk factors are influenced by regional disparities driven by socio-economic deprivation. This study aims to analyse the trends in PLC incidence in Scotland by cancer networks from 2000 to 2023. MATERIAL AND METHODS: PLC patients, defined as ICD-10 C22 topographic code, were extracted from the Scottish Cancer Registry between 2000 and 2023. There are three cancer networks in Scotland: North of Scotland (NoS), Southeast of Scotland (SEoS) and West of Scotland (WoS). The European age-standardised incidence rate was annually calculated. Joinpoint regression analysis identified the turning points in incidence trends by cancer networks. The distribution of age and sex were evaluated using Chi-squared tests. RESULTS: A total of 11,933 PLC cases in Scotland were recorded between 2000 and 2023. WoS accounted for the largest proportion of cases (48.9 %), followed by SEoS (26.8 %) and NoS (24.3 %). An epidemiological shift experienced in the mid-2010s: incidence rates increased from 2000 before plateauing in 2013 for SEoS, 2014 for WoS and Scotland, and 2015 for NoS. WoS exhibited a distinct demographic profile, characterised by higher proportions of male (68.2 %) and higher proportions of patients under age 70 (43.8 %) compared to the national average (p < 0.05). CONCLUSION: PLC incidence by cancer networks transitioned from a period of rapid growth to a stabilised plateau in the mid-2010s. WoS is characterised by the highest incidence rates and more males, a younger age profile compared to other networks. The high burden in WoS underscores a need for region-specific strategies in Scotland.