Infections and Immunoepidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA.
Division of Gastroenterology and Hepatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Cancer Med. 2023 Oct;12(19):19960-19967. doi: 10.1002/cam4.6537. Epub 2023 Sep 30.
Hepatocellular carcinoma (HCC) incidence was rising in the United States. Previously, using data collected by the Surveillance, Epidemiology, and End Results (SEER) Program through 2017, we found that overall incidence had begun to decline, although not in Black and American Indian/Alaska Native (AI/AN) populations. Utilizing expanded SEER data encompassing ~50% of the population, we examined secular trends and demographic differences in HCC incidence through 2019.
We included cases of HCC diagnosed in adults aged ≥20 years residing in SEER-22 registry areas. We examined case counts, incidence rates (per 100,000 person-years), annual percent changes (APCs), and calendar years when APCs changed significantly.
HCC incidence increased from 5.56 in 2000 to 8.89 in 2009 (APC, 5.17%), then rose more slowly during 2009-2015 (APC, 2.28%). After peaking at 10.03 in 2015, incidence fell to 9.20 in 2019 (APC, -2.26%). In Asian/Pacific Islanders (A/PI), the decline began in 2007 and accelerated in 2015 (APCs: 2007-2015, -1.84%; 2015-2019, -5.80%). In 2014, incidence began to fall in the White (APC: 2014-2019, -1.11%) and Hispanic populations (APC: 2014-2019, -1.72%). In 2016, rates began to fall in Black individuals (APC: 2016-2019, -6.05%). In the AI/AN population, incidence was highest in 2017, although the subsequent decline was not statistically significant. In 2019, population-specific rates were: White, 6.94; Black, 10.74; A/PI, 12.11; AI/AN, 14.56; Hispanic, 15.48.
HCC incidence is now decreasing in most US racial/ethnic populations, including among Black individuals. The onset of decline differed among racial/ethnic groups and wide disparities in HCC rates remain.
在美国，肝细胞癌 (HCC) 的发病率一直在上升。此前，我们利用监测、流行病学和最终结果 (SEER) 计划在 2017 年之前收集的数据发现，总体发病率已经开始下降，尽管黑人和美洲印第安人/阿拉斯加原住民 (AI/AN) 人群的发病率没有下降。利用涵盖约 50%人口的扩展 SEER 数据，我们通过 2019 年检查了 HCC 发病率的长期趋势和人口统计学差异。
我们纳入了年龄≥20 岁、居住在 SEER-22 登记地区的成年人中诊断为 HCC 的病例。我们检查了病例数、发病率（每 10 万人年）、年百分比变化 (APC)，以及 APC 发生显著变化的日历年份。
HCC 的发病率从 2000 年的 5.56 上升到 2009 年的 8.89（APC 为 5.17%），然后在 2009-2015 年期间缓慢上升（APC 为 2.28%）。在 2015 年达到 10.03 的峰值后，发病率在 2019 年下降到 9.20（APC 为-2.26%）。在亚洲/太平洋岛民 (A/PI) 中，下降始于 2007 年，并在 2015 年加速（APC：2007-2015 年，-1.84%；2015-2019 年，-5.80%）。2014 年，白人（APC：2014-2019 年，-1.11%）和西班牙裔（APC：2014-2019 年，-1.72%）人群的发病率开始下降。2016 年，黑人的发病率开始下降（APC：2016-2019 年，-6.05%）。在美洲原住民/阿拉斯加原住民人群中，发病率在 2017 年最高，尽管随后的下降没有统计学意义。2019 年，特定人群的发病率为：白人，6.94；黑人，10.74；亚洲/太平洋岛民，12.11；美洲原住民/阿拉斯加原住民，14.56；西班牙裔，15.48。
现在，美国大多数种族/族裔人群的 HCC 发病率都在下降，包括黑人。下降的开始在不同种族/族裔群体之间有所不同，HCC 发病率仍存在巨大差距。
