Demographic inequalities in mortality due to hepatocellular cancer in male patients with alcoholic cirrhosis across the United States: A CDC WONDER database analysis.

Abstract

e22558 Background: Hepatocellular carcinoma (HCC) is the sixth most common cancer globally and ranks as the third-leading cause of cancer-related deaths. Among the various forms of chronic liver disease, alcohol-related liver disease is the most prevalent, contributing to 30% of HCC cases and HCC-specific fatalities worldwide. In the United States, HCC mortality rates have shown an increase in recent years, accompanied by significant racial disparities. This study aimed to examine alcoholic cirrhosis associated HCC mortality trends and disparities by sex and race in the United States between 1999 and 2020. Methods: Using the CDC Wonder database, we examined mortality trends from 1999 to 2020. We investigated deaths attributed to hepatocellular cancer which prevailed in patients with alcoholic cirrhosis, identified by the ICD-10 code C22 and K70.3, and excluded female individuals and individuals below the age of 15. Overall trends in deaths were noted and further stratified based on age and race. States were ranked based on their mortality rate. The Mann–Kendall trend test was used to investigate temporal trends and a t-test was used to compare continuous variables. Results: During the study period, a total of 9,837 deaths were attributed to hepatocellular carcinoma associated with alcoholic cirrhosis, with an overall age-adjusted mortality rate (AAMR) of 0.338 (95% CI: 0.332–0.345). A significant upward trend in mortality was observed over the study period (p < 0.001). Stratification by age and race revealed that young men (AAMR: 0.241), older men (AAMR: 0.848), and white men (AAMR: 0.338) exhibited significant increases in AAMR (p < 0.001). A statistically significant difference was identified in mortality rates between older and younger men (p < 0.001); however, no significant differences were observed when comparing racial groups (Black vs. White). State-level analysis showed the highest mortality rates in New Mexico (AAMR: 0.813), Vermont (AAMR: 0.790), and Oregon (AAMR: 0.737), while the lowest rates were recorded in Mississippi (AAMR: 0.132), Utah (AAMR: 0.132), and New Jersey (AAMR: 0.120). Conclusions: The increasing mortality rate of hepatocellular carcinoma associated with alcoholic cirrhosis poses a significant challenge for healthcare providers and policymakers. Public education on the harmful effects of alcohol consumption is essential to raise awareness and promote preventive measures. Additionally, further research is needed to develop and implement evidence-based strategies to address this growing health concern effectively.