Temporal trends and racial/ethnic disparities in hepatocellular carcinoma incidence in the US between 2000-2022

BACKGROUND & AIMS: Hepatocellular carcinoma (HCC) in the US is largely driven by chronic hepatitis B in non-Hispanic Asians/Pacific Islanders (NH API) and chronic hepatitis C and metabolic dysfunction-associated steatotic liver disease in other racial/ethnic groups. We examined temporal trends and racial/ethnic disparities in HCC incidence in the US. METHODS: The SEER-21 database (1 January 2000-31 December 2022) was used to identify adults aged ≥30 years diagnosed with HCC. Annual percentage changes (APC) in HCC incidence were estimated using Joinpoint regression. RESULTS: = -4.8; p <0.05), nearly a decade before the other groups. AAIR began declining in NH Black and NH American Indian/Alaska Native populations in 2016, decreasing by 5.7% and 5.0% annually, respectively (p <0.05), and in 2019 in Hispanic and NH White, decreasing by 4.4% and 3.6% annually, respectively (p <0.05). CONCLUSIONS: HCC incidence trends varied by race/ethnicity. Declines may be partly associated with national hepatitis screening and treatment initiatives and professional guidelines, emphasizing continued efforts to address both viral and non-viral causes. IMPACT AND IMPLICATIONS: Early declines among non-Hispanic Asians/Pacific Islanders likely reflect increased treatment for chronic hepatitis B, while later declines among the whole population were likely the result of national initiatives to scale up curative hepatitis C treatment. The high incidence of hepatocellular carcinoma (HCC) in Hispanic individuals warrants further studies and targeted interventions, including efforts to increase hepatitis C treatment access and reduce metabolic dysfunction-associated steatotic liver disease. These findings are important for clinicians and policymakers addressing HCC disparities and show that increased national initiatives to improve the diagnosis and treatment of chronic viral hepatitis are associated with a declining trend in HCC incidence at the population level.