Clin Mol Hepatol.  2024 Oct;30(4):756-770. 10.3350/cmh.2024.0318.

Burden of mortality from hepatocellular carcinoma and biliary tract cancers by race and ethnicity and sex in US, 2018–2023

Affiliations
  • 1Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA, USA
  • 2Department of Medicine, Division of Gastroenterology and Hepatology, University of Arizona College of Medicine, Phoenix, AZ, USA
  • 3Department of Internal Medicine, Division of Gastroenterology and Hepatology, Banner University Medical Center, Phoenix, AZ, USA
  • 4Liver Center, Division of Abdominal Transplantation, Michael E DeBakey Department of General Surgery, Baylor College of Medicine, Houston, TX, USA
  • 5Section of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, Houston, TX, USA

Abstract

Backgrounds/Aims
The trends in mortality of hepatocellular carcinoma (HCC) and biliary tract cancers stratified by sex and race/ethnicity in the US continue to evolve. We estimated the sex- and race/ethnicity-based trends in HCC and biliary tract cancers-related mortality in US adults with a focus on disease burden.
Methods
We performed a population-based analysis using the US national mortality records from 2018 to 2023. We identified HCC and biliary tract cancer using appropriate ICD-10 codes. Temporal trends in mortality were calculated by joinpoint analysis with annual percentage change (APC).
Results
Annual age-standardized mortality from HCC decreased steadily with an APC of –1.4% (95% confidence interval [CI]: –2.0% to –0.7%). While there was a linear increase in intrahepatic cholangiocarcinoma-related mortality (APC: 3.1%, 95% CI: 1.2–4.9%) and ampulla of Vater cancer-related mortality (APC: 4.1%, 95% CI: 0.5–7.9%), gallbladder cancer-related mortality decreased (APC: –1.9%, 95% CI: –3.8% to –0.0%). Decreasing trends in mortality from HCC were noted in males, not females. HCC-related mortality decreased more steeply in racial and ethnic minority individuals compared with non-Hispanic White individuals. Racial and ethnic differences in trends in mortality for biliary tract cancers depended on the malignancy’s anatomical site.
Conclusions
While the annual mortality for HCC and gallbladder cancer demonstrated declining trends, ICC- and AVC-related mortality continued to increase from 2018 to 2023. Although racial and ethnic minority individuals in the US experienced disproportionately higher HCC and biliary tract cancer, recent declines in HCC may be primarily due to declines among racial and ethnic minority individuals and males.

Keyword

Liver cancer; Cholangiocarcinoma; Gallbladder cancer; NVSS; Death
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