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Hepatocellular carcinoma incidence to increase through 2030

In a new study published in the Journal of Clinical Oncology, hepatocellular carcinoma incidence rates in Hispanics and blacks are expected to increase in the U.S. through 2030.

“HCC incidence is forecast to increase through 2030. Treatment of hepatitis C virus infections with second-generation direct-acting antivirals has the potential to dramatically decrease these trends. However, metabolic disorders will continue to be important risk factors for hepatocellular carcinoma in the U.S.,” Jessica L. Petrick, PhD, MPH, CRTA post-doctoral fellow, division of cancer epidemiology and genetics National Cancer Institute, told Healio.com/Hepatology.

Jessica L. Petrick

Petrick and colleagues analyzed single-year population and HCC incidence data of individuals aged 35 to 84 years from the Surveillance, Epidemiology and End Results (SEER) 18 Registry Database. Data ranged between the years 2000 and 2012 and researchers used age-period cohort (APC) models to predict incidence rates from 2013 to 2030. To determine HCC incidence by birth cohort, the researchers used the SEER 9 Registry Database for 1975 to 2012.

Results showed that observed and projected HCC incidence rates were 3.5 times higher among men than women.

Incidence rates of HCC among all racial and ethnic groups increased between 2000 and 2012, except among Asians and Pacific Islanders. This ethnic group had the highest incidence of HCC, but incidence has stabilized. Between 2013 and 2030, HCC incidence rates among Asians and Pacific Islanders are expected to decrease, with estimated annual percentage changes of −1.59% for men and −2.20% for women.

“Thus, by 2030, Asians and Pacific Islander men are forecast to have the lowest incidence rates among men and among women, have rates similar to rates of white women.,” the researchers wrote

HCC rates among Hispanics are expected to continue to increase and then stabilize between 2025 and 2030. By 2030, Hispanics are forecasted to have the highest rates among men (age-standardized ratio: 44.2) and second highest among women (age-standardized ratio: 12).  Incidence rates of HCC among blacks are expected to increase for both men and women. However, HCC rates for men will begin to decrease slightly between 2025 and 2030.  Black women are expected to have the highest HCC rates among women by 2030.

Incidence of HCC increased with each successive birth cohort through 1959. However, rates began to decrease with the 1960 to 1969 birth cohorts. An increase in HCC incidence is expected among 65- and 85-year olds between 2013 and 2030.due to the aging of the birth cohorts, according to the research. The forecasted rates will continue to increase as the birth cohort from 1945 to 1965 age, but HCC incidence rates in the younger birth cohorts will decrease.

“Our research identifies groups at greatest risk who may benefit most from prevention efforts: individuals born between 1950 and 1959, Hispanics and blacks,” Petrick said.

Whites are forecasted to continue to have low HCC rates, compared with other racial groups. Whites will have the greatest number of HCC cases because of the proportion of the population they represent. However, between 2013 to 2030, HCC cases among Hispanics will increase (140.58%) as the Hispanic population continues to grow.

A sensitivity analysis showed that if 50% of HCV infections are treated by 2030, HCC rates will “plateau” by 2025. If 80% are treated by 2030, then HCC rates will begin to decrease, according to the research.

“Continued efforts should be focused on identifying and treating HCV among the baby boomer cohort, particularly for the birth cohorts of 1950 to 1959, where the highest HCC rates are noted,” the researchers wrote.

The researchers concluded: “In the next 15 years, we project that HCC incidence rates among Asians and Pacific Islanders will begin to decline and rates among whites will continue to increase. However, rates will remain highest in the black and Hispanic populations.”

Disclosure: The researchers report no relevant financial disclosures.