Healthcare disparities in hepatocellular carcinoma mortality across different racial groups in the United States: A SEER-based analysis (2000–2020).

Abstract

e13792 Background: Hepatocellular cancer (HCC) is the most common primary liver malignancy in the United States. The purpose of our study is to assess the healthcare disparities in HCC. Methods: Our study utilized SEER incidence-based mortality (IBM) data of HCC analyzing age-adjusted temporal trends from 17 registries (2000–2020), highlighting the racial disparities among Caucasian, African American (AA), American Indians/Alaska Natives(AI/AN), and Asian/Pacific Islanders (A/PI). Rates were calculated per 100,000 and age-adjusted to the 2000 US standard population. Results: Caucasians: Mortality rates increased steadily from 5.4 (2000) to 13.9 (2015), followed by stabilization and a slight decline to 13.2 (2020). The overall annual percentage change (APC) was 3.0% (p < 0.05), significantly slowing in recent years. AA: IBM peaked in 2013 (19.2) before declining to 16.3 (2020). The APC showed early growth (2.1%, p < 0.05) followed by a modest decline (-1.7%, p < 0.05) since 2013. AI/AN: Mortality rates grew rapidly from 10.6 (2000) to 23.8 (2015) but declined significantly thereafter to 18.7 (2020). The APC showed the steepest growth from 2000–2007 (6.85%, p < 0.05) and a decline (-3.48%, p < 0.05) from 2017–2020. A/PI: Asian/Pacific Islanders exhibited the increasing mortality rates initially, from 13.2 (2000) to 24.4 (2008), but rates declined sharply to 17.3 (2020). The APC was 33.7% (2000–2004, p < 0.05), followed by a significant negative trend (-4.06%, p < 0.05) from 2014–2020. Conclusions: Despite recent improvements, disparities persists. IBM rates initially increased and then started declining for all races, with rates being lowest among Caucasians and highest among A/PI. The APC was highest among Asian/Pacific Islanders and lowest among Caucasian populations. Public health initiatives must prioritize reducing disparities and accelerating declines in liver cancer mortality across all racial and ethnic groups. Year Caucasian African American American Indian/Alaska Native Asian or Pacific Islander Rate SE Rate SE Rate SE Rate SE 2000 5.4 0.1 7.5 0.5 10.6 2.4 13.2 0.8 2001 7.7 0.2 11.6 0.7 11.4 2.2 19.7 1 2002 8.2 0.2 12.6 0.7 10.8 2.2 23.2 1 2003 9.2 0.2 12.6 0.7 12.3 2.3 24.3 1 2004 9.2 0.2 14.1 0.7 14.5 2.3 24.1 1 2005 9.8 0.2 14.9 0.7 13.8 2.2 24.9 1 2006 10.6 0.2 15.7 0.7 14.9 2.4 23.9 0.9 2007 10.9 0.2 14.9 0.7 17 2.5 22.8 0.9 2008 11.3 0.2 16.3 0.7 19.2 2.5 24.4 0.9 2009 11.9 0.2 17.6 0.7 17.8 2.4 22.5 0.8 2010 12.1 0.2 17.3 0.7 18.4 2.3 23.2 0.8 2011 12.3 0.2 16.5 0.7 15.6 2.1 23.1 0.8 2012 13.4 0.2 18.1 0.7 14.3 1.9 22 0.8 2013 13.7 0.2 19.2 0.7 19.4 2.3 21.6 0.8 2014 13.9 0.2 19.8 0.7 19.2 2.2 21.9 0.7 2015 13.9 0.2 18.8 0.7 23.8 2.4 21.3 0.7 2016 13.3 0.2 16.9 0.6 19.4 2.1 20.1 0.7 2017 13.6 0.2 17.2 0.6 21.7 2.2 18.7 0.6 2018 13.8 0.2 19.2 0.7 20.1 2 18.2 0.6 2019 13.4 0.2 17.6 0.6 20.6 2 18.1 0.6 2020 13.2 0.2 16.3 0.6 18.7 1.9 17.3 0.6 IBM Trends of Different Races in the US, 2000-2020.