Trends in disability-adjusted life years from hepatitis C–related liver cancer in the United States: A Global Burden of Disease study.

Abstract

e16194 Background: Hepatitis C virus (HCV)–related mortality has declined in the United States, largely due to the widespread use of highly effective direct-acting antiviral (DAA) therapies. Despite this progress, the burden of HCV-related liver cancer appears to be rising. We examined long-term trends in disability-adjusted life years (DALYs) attributable to HCV-related liver cancer in the United States. Methods: Data were obtained from the Global Burden of Disease (GBD) 2021 study. DALYs attributable to hepatitis C–related liver cancer were extracted for the United States and analyzed from 1990 to 2021. Temporal trends were assessed using linear regression and the Mann–Kendall trend test. Results: DALYs from HCV-related liver cancer increased steadily throughout the study period. Linear regression demonstrated an average annual increase of 1,646 DALYs per 100,000 population (β = 1,646; p < 0.001; R² = 0.99). The Mann–Kendall trend test confirmed a significant upward monotonic trend (Z = 7.9; p < 0.001), consistent with the regression findings. Conclusions: Despite substantial reductions in HCV-related mortality following the introduction of DAAs, the burden of HCV-related liver cancer in the United States continues to rise. This pattern likely reflects the long latency of hepatocarcinogenesis in chronic HCV infection, particularly among individuals born between 1945 and 1965, who account for the majority of chronic infections. These findings highlight the ongoing need for targeted HCV screening, early treatment, and long-term surveillance in high-risk populations to mitigate future liver cancer burden.