Background/Objectives:Hepatocellular carcinoma (HCC) is a leading cause of cancer diagnoses and deaths in the United States. This study serves as an update on secular trends in national HCC incidence rates while exploring potential geographic and racial/ethnic differences across all nine US census divisions.Methods: We analyzed HCC incidence data reported to the United States Cancer Statistics (USCS) database from 2001 to 2021 (excluding 2020 data, based on the Centers for Disease Control and Prevention’s cautionary recommendations for COVID-19 pandemic data usage for trend analysis). We performed trend analyses of age-adjusted incidence rates in the US overall, by census divisions, and then stratified by race/ethnicity, using the National Cancer Institute’s Joinpoint Regression Program.Results: Between 2001 and 2021, HCC incidence rates increased nationally, with an average annual percentage change (AAPC) of 2.51 (95% confidence interval (CI): 2.32–2.72); however, the rate decreased (annual percentage change (APC) −3.33 (95% CI: −4.78–−1.96) in recent years from 2018 to 2021. Division 1 had the greatest decrease (APC −6.46 (95% CI: −9.62–−3.96) from 2017 to 2021, while rates leveled in Division 6 (East South Central) and Division 7 (West South Central). HCC trends decreased substantially for non-Hispanic Black and Non-Hispanic Asian and Pacific Islander groups in almost all divisions in recent years, but trends were stable, decreased, or increased for other racial/ethnic populations.Conclusions: Despite declining national HCC incidence rates, these trends were not uniform across racial/ethnic groups or US census divisions. Race-specific interventions are needed to reduce disparities in HCC incidence in all US census divisions.
背景/目的：肝细胞癌（HCC）是美国癌症诊断和死亡的主要原因之一。本研究旨在更新美国全国HCC发病率的时间趋势，并探讨美国九个普查分区之间潜在的地理及种族/民族差异。 方法：我们分析了2001年至2021年上报至美国癌症统计（USCS）数据库的HCC发病率数据（根据美国疾病控制与预防中心关于在趋势分析中使用COVID-19大流行数据的审慎建议，排除了2020年数据）。我们使用美国国家癌症研究所的Joinpoint回归程序，对美国总体、按普查分区以及按种族/民族分层后的年龄调整发病率进行了趋势分析。 结果：2001年至2021年间，美国全国HCC发病率呈上升趋势，平均年度百分比变化（AAPC）为2.51（95%置信区间（CI）：2.32–2.72）；然而，近年来（2018年至2021年）发病率有所下降，年度百分比变化（APC）为-3.33（95% CI：-4.78–-1.96）。其中，第1分区（新英格兰地区）从2017年至2021年下降幅度最大（APC -6.46，95% CI：-9.62–-3.96），而第6分区（东中南地区）和第7分区（西中南地区）的发病率趋于平稳。近年来，在几乎所有分区中，非西班牙裔黑人和非西班牙裔亚裔及太平洋岛民群体的HCC发病率均显著下降，但其他种族/民族群体的趋势则保持稳定、下降或上升。 结论：尽管全国HCC发病率呈下降趋势，但这些趋势在不同种族/民族群体或美国普查分区之间并不一致。需要采取针对特定种族的干预措施，以减少美国所有普查分区中HCC发病率的差异。
Differences in Hepatocellular Carcinoma Incidence Trends Across US Census Divisions, 2001 to 2021
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