e16489 Background: Hepatocellular Carcinoma (HCC) and Intrahepatic Cholangiocarcinoma (ICC) are the two most common types of primary liver cancers and together account for a substantial proportion of cancer incidence worldwide. These remain a major global health concern, with a high prevalence in the United States. This study aims to compare trends and geodemographic disparities in mortality from HCC and ICC in the U.S. from 1999 to 2024. Methods: We conducted a comparative analysis of mortality between HCC and ICC using CDC WONDER Multiple Cause of Death data and ICD-10 codes for HCC (C22.0) and ICC (C22.1). Age Adjusted Mortality Rates (AAMRs) per 1million of adults aged ≥ 45years were calculated and stratified by gender, ethnicity, age, and demographic variables. Join point regression was employed to assess the Average Annual Percentage Change (AAPC) with 95% Confidence Interval (CI). * Indicates p < 0.05. Results: From 1999 to 2024, a total of 258,738 deaths were recorded due to HCC, and 149,258 deaths were attributed to ICC. Despite more deaths due to HCC, mortality due to ICC increased more rapidly (AAPC: 3.57*) than HCC (AAPC: 2.07*) over the past two decades. The persistent increase was observed in the females for both ICC (AAPC: 3.70*) and HCC (AAPC: 2.01*) as compared to the males with (AAPC: 3.37*) and (AAPC: 1.89*) respectively. Among age groups, adults aged 45-64 years are more affected by ICC (AAPC: 4.01*) as compared to HCC (AAPC: 0.41*). But individuals of age ≥ 65years are aggressively affected by both, ICC (AAPC: 3.41*) and HCC (AAPC: 2.95*). Across racial groups, ICC caused a more pronounced increase in Non-Hispanic (NH) Blacks (AAPC: 4.22*) and NH Whites (AAPC: 3.62*) as compared to other groups. Similarly, HCC also affected the NH Blacks (AAPC: 1.42*) and NH Whites (AAPC: 2.51*) but a significant decrease in NH Asians (AAPC: -2.22*) was observed. Regionally, ICC caused a significant and steady increase in mortality across all census regions with AAPC ranging from 3.28* to 3.83* but HCC greatly affected the south region (AAPC: 2.63*), and the northeast (AAPC: 1.28*) was least affected. Mortality due to ICC was higher in metropolitan areas (AAPC: 3.51*) while HCC affected non-metropolitan areas (AAPC: 4.03*). Conclusions: Our findings revealed distinct differences in mortality due to HCC and ICC in the United States. Overall, ICC demonstrated a steady increase in mortality as compared to HCC. Adults aged 45-64years are more susceptible to ICC while adults aged 65+ are more vulnerable to HCC. Urban areas have a high incidence of ICC, and rural areas are more affected by HCC. These findings highlight the need for effective screening measures aligned with AASLD guidelines, targeted prevention strategies, and public health initiatives to address persistent and widening disparities among the high-risk populations.
Nwokeocha et al. (Thu,) studied this question.