Incidence of viral and non-viral etiologies of hepatocellular carcinoma (HCC) in the US over time by race and ethnicity.

Abstract

10551 Background: HCC has an incidence of 5–6 cases per person-yr in the US, with varying rates among different racial and ethnic groups. While viral HCC accounts for ~50% of all HCC cases in North America, recently, a shift from viral to non-viral HCC was observed in the US. Here, we investigate the incidence of viral and non-viral HCC over time across different racial and ethnic groups in the US. Methods: This is a cross-sectional study using data from the TARGET-HCC registry, a longitudinal observational cohort study enrolling adult patients (pts) with newly diagnosed HCC across 43 academic and community centers in the US. Pts were enrolled from 1 Jan 2017 to 30 Sep 2023, and consented to share medical records 36 mo retrospectively and prospectively for up to 60 mo. Results: Among 2,924 enrolled pts, etiology was available for 2,139 (73%). Median (IQR) age was 64 (59, 68) yr and 77% were male. At HCC diagnosis, 66% of pts had BCLC stage 0/A, 16% BCLC B, 13% BCLC C, and 6% BCLC D; 69% of pts had Child-Pugh class A, 26% class B, and 5% class C. 1,727 (81%) pts had underlying cirrhosis. 1,484 (72%) pts were White, 414 (20%) Black/African American (Black/AA), 86 (4%) Asian/Native Hawaiian or Pacific Islander (Asian/NH/PI), and 68 (3%) American Indian/Alaskan Native. 1,786 (87%) pts were of non-Hispanic ethnicity and 257 (13%) of Hispanic ethnicity. The incidence of viral and non-viral HCC over time by race and ethnicity is shown in the Table. In the overall population, although the incidence of viral HCC decreased over time, it remained higher than that of non-viral HCC across all periods. The proportion of pts diagnosed with viral vs non-viral HCC was 75% vs 59% in 2014–2016, 69% vs 55% in 2017–2019, and 65% vs 57% in 2020–2023. Conclusions: Despite variations in the number of pts enrolled in each period, there is an overall trend of decreasing incidence of viral HCC over time across all racial groups. The incidence of viral HCC has declined among non-Hispanics but increased among Hispanics. Nevertheless, non-viral liver disease remains the most common cause of HCC in Hispanics. 2014–2016 2017–2019 2020–2023 Race (R)/Ethnicity (E) a Total, N Viral, n (%) Non-Viral, n (%) Total, N Viral, n (%) Non-Viral, n (%) Total, N Viral, n (%) Non-Viral, n (%) Overall, N=2138 b 545 411 (75) 324 (59) 1441 994 (69) 793 (55) 152 99 (65) 87 (57) R: White 371 253 (68) 241 (65) 1003 631 (63) 608 (61) 110 66 (60) 71 (65) R: Black/AA 114 111 (97) 53 (46) 268 243 (91) 97 (36) 32 29 (91) 9 (28) R: Asian/NH/PI 25 23 (92) 9 (36) 61 46 (75) 26 (43) 0 0 0 R: American Indian/Alaska Native 12 9 (75) 5 (42) 55 37 (67) 32 (58) 1 0 1 (100) E: Non-Hispanic 454 352 (78) 263 (58) 1210 842 (70) 658 (54) 121 78 (64) 66 (55) E: Hispanic 62 35 (56) 43 (69) 174 107 (61) 109 (63) 21 14 (67) 16 (76) The percentage may add to more than 100 because pts have mixed etiologies. a Etiology for 7 pts of “Other” ethnicities: 2 viral in 2014–2016; 4 viral and 3 non-viral in 2017–2020. b 1 pt diagnosed ≤2013 not included.