Temporal trends and disparities in liver cancer incidence in the United States, 1999–2022: A Joinpoint regression analysis.

Abstract

e16307 Background: Liver cancer incidence has changed substantially in the United States over the past two decades, with notable variation across demographic subgroups. A detailed evaluation of long-term trends and population disparities is essential to characterize the evolving burden of disease. Methods: Liver cancer incidence data from 1999 to 2022 were obtained from the CDC WONDER database. Age-adjusted incidence rates were calculated per 100,000 population using the 2000 U.S. standard population. Analyses were stratified by sex, age group (< 40, 40–74, > 70 years race and ethnicity (Non-Hispanic White, NH Black's, NH Asian or Pacific Islander, NH American Indian or Alaska Native, and Hispanic). Joinpoint regression was used to estimate annual percent change (APC) and average annual percent change (AAPC) with 95% confidence intervals (CIs). Results: A total of 545,380 incident liver cancer cases were identified in the United States and Puerto Rico. Incidence increased from 4.06 in 1999 to 6.39 in 2022. Two joinpoints were identified, with incidence rising from 1999–2008 (APC 4.94%, 95% CI 4.35%–6.25%), increasing more modestly from 2008–2015 (APC 2.64%, 95% CI 1.39%–3.42%), and declining from 2015–2022 (APC −2.05%, 95% CI −2.88% to −1.39%). Overall, the AAPC was 2.07% (95% CI 1.88%–2.31%). Incidence remained higher in males than females. Among females, rates increased from 2.23 to 3.26 (AAPC 1.81%, 95% CI 1.61%–2.03%), while among males, rates rose from 6.30 to 9.96 (AAPC 1.97%, 95% CI 1.77%–2.19%). Incidence changed minimally among individuals < 40 years (AAPC 0.83%, 95% CI 0.44%–1.24%), increased most steeply among those aged 40–74 years (AAPC 3.22%, 95% CI 3.02%–3.47%), and was highest among adults > 70 years (AAPC 2.11%, 95% CI 1.79%–2.52%). Incidence increased among American Indian or Alaska Native, White, Black, and Hispanic populations, while declining among Asian or Pacific Islander individuals (AAPC −2.03%, 95% CI −2.32% to −1.68%). Conclusions: Liver cancer incidence in the United States increased substantially from 1999 through the mid-2010s, followed by a recent decline. The steepest increases occurred among adults aged 40–74 years, while Asian or Pacific Islander populations experienced sustained reductions. Persistent sex-, age-, race-, and ethnicity-based disparities highlight the need for targeted prevention, early detection, and risk-factor mitigation strategies.