Incidence of Hepatocellular Carcinoma May Decline

Researchers from the National Cancer Institute are predicting that the rate of hepatocellular carcinoma (HCC) in the United States will likely decrease by the year 2030, a new study published in the Journal of Clinical Oncology indicates.

“Although liver cancer has long had some of the most rapidly increasing incidence rates, the decreasing rates already seen among Asian/Pacific Islanders, individuals younger than 65 years, and birth cohorts born after 1959 suggest that we may see continued declines in incidence of HCC in future years,” wrote Jessica L. Petrick, PhD, MPH, of the National Cancer Institute, and colleagues, who also noted that “the estimates of future incidence and burden in this study are the best assessment in light of current data.”

According to the study, HCC has a poor prognosis and researchers are trying to find way to inform prevention and treatment strategies in order to reduce the incidence of HCC. In this study, Petrick and colleagues used HCC incident case and population data from the SEER 18 Registry Database for years 2000 to 2012 and people aged 35 to 84. Using this data, they created models to forecast incident HCC cases through year 2030.

Data from 2000 to 2012 revealed that Asian/Pacific Islanders had the highest rates of HCC, but that the incidence is beginning to level out. In contrast, rates of HCC increased during this time among people of other racial/ethnic groups.

Examination of age-specific incidence showed that HCC increased with each cohort born through 1959, but that rates began to decrease with the 1960 to 1969 birth cohorts.

The researchers used their models to calculate age-standardized incidence rates (ASRs) per 100,000 person-years. They found that by 2030, Asian/Pacific Islanders were predicted to have the lowest incident rates of HCC among men (ASR = 26.3) and rates similar to white women among women (ASR = 7.6).

By 2030, Hispanic men will have the highest rates of HCC (ASR = 44.2) and Hispanic women will have the second highest rates (ASR = 12.0) behind black women (ASR = 12.82). Rates among Hispanics and blacks are predicted to continue to increase, but will stabilize or decrease slightly between 2025 and 2030.

According to the researchers, about one-third of cases of HCC are attributed to obesity and diabetes. The rate of obesity in the United States was about 35% in 2012, but is predicted to increase to 40% to 50% of the population by 2030.

“We observed the effects of metabolic disorders in our HCC forecasts, because the subgroups with the highest obesity prevalence (ie, blacks and Hispanics) also have the highest forecast HCC rates,” the researchers wrote.

In addition to focusing on obesity, the researchers recommended increased efforts to vaccinate against and treat hepatitis C virus among baby boomers, specifically those born between 1950 and 1959.

“Prevention efforts should focus on Hispanics and blacks, because both populations have high HCC rates, which will continue to increase in the coming years,” the researchers wrote.