Between 2001 and 2022, US HCC incidence declined in metropolitan counties but increased in non-metropolitan counties by 1.1% annually in men and 1.7% annually in women.
Observational (n=264,633)
Yes
Despite a recent decline in national HCC incidence, increasing incidence in nonmetropolitan areas and select states highlights the need for rural- and state-specific strategies for risk reduction and early detection.
e16281 Background: Hepatocellular carcinoma (HCC) incidence in the United States has recently stabilized or declined; however, substantial geographic variation in underlying risk factors may result in heterogeneous state-level trends and rural-urban disparities. We evaluated recent state-level and rural–urban trends in HCC incidence across the United States. Methods: We analyzed incident HCC cases from the National Program of Cancer Registries and the Surveillance, Epidemiology, and End Results program, covering all 50 states and the District of Columbia from 2001–2022. HCC was identified using ICD-O-3 site code C22.0 and histology codes 8170–8175. Annual age-adjusted incidence rates (per 100,000 persons), standardized to the 2000 U.S. population, were estimated using SEER*Stat v9.0.42.0. Temporal trends were assessed using Joinpoint regression (v5.4.0) to estimate annual percent changes (APCs). Data from 2020 were excluded due to COVID-19–related reporting disruptions. Results: A total of 264,633 HCC cases were identified; 77% occurred among men and 87% were diagnosed in urban counties. Overall incidence was 5.6 per 100,000 (95% CI, 5.40–5.76) in men and 1.5 per 100,000 (95% CI, 1.42–1.50) in women. Among men, incidence declined in metropolitan counties by 1.4% annually (95% CI, −1.7 to −1.1) from 2008 to 2022, while increasing in non-metropolitan counties by 1.1% annually (95% CI, 0.6–1.6) during 2007-2022, state-level incidence ranged from 3.6 per 100,000 in South Dakota to 9.0 per 100,000 in Texas and recent declines were observed in 22 states (APC range, −1.2% to −12.6%), whereas increasing trends were identified in Kentucky, Texas, Utah and West Virginia. Among women, incidence declined in metropolitan counties by 1.0% annually (95% CI, −1.4 to −0.6) during 2009-2022 but increased in non-metropolitan counties by 1.7% annually (95% CI, 1.2–2.3) from 2001 to 2022, state-level incidence ranged from 1.1 per 100,000 in Wyoming to 3.1 per 100,000 in New Mexico and decreasing trends in recent years were also observed in 7 states (APC range, −0.9% to −3.4%), whereas increasing trends were observed in Arkansas and Kansas. Conclusions: Despite a recent decline in national HCC incidence, we reported that state-level and rural–urban disparities persist. Particularly, increasing incidence in nonmetropolitan areas and select states highlights the need for rural- and state-specific strategies for risk reduction and early detection. Future studies are needed to investigate the factors contributing to disparities in these states and rural areas.
Uygun et al. (Thu,) conducted a observational in Hepatocellular carcinoma (n=264,633). Between 2001 and 2022, US HCC incidence declined in metropolitan counties but increased in non-metropolitan counties by 1.1% annually in men and 1.7% annually in women.