Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA, USA.
Department of Medicine, Division of Gastroenterology and Hepatology, University of Arizona College of Medicine, Phoenix, AZ, USA.
Clin Mol Hepatol. 2024 Oct;30(4):756-770. doi: 10.3350/cmh.2024.0318. Epub 2024 Jun 24.
BACKGROUNDS/AIMS: The trends in mortality of hepatocellular carcinoma (HCC) and biliary tract cancers stratified by sex and race/ethnicity in the US continue to evolve. We estimated the sex- and race/ethnicity-based trends in HCC and biliary tract cancers-related mortality in US adults with a focus on disease burden.
We performed a population-based analysis using the US national mortality records from 2018 to 2023. We identified HCC and biliary tract cancer using appropriate ICD-10 codes. Temporal trends in mortality were calculated by joinpoint analysis with annual percentage change (APC).
Annual age-standardized mortality from HCC decreased steadily with an APC of -1.4% (95% confidence interval [CI]: -2.0% to -0.7%). While there was a linear increase in intrahepatic cholangiocarcinoma-related mortality (APC: 3.1%, 95% CI: 1.2-4.9%) and ampulla of Vater cancer-related mortality (APC: 4.1%, 95% CI: 0.5-7.9%), gallbladder cancer-related mortality decreased (APC: -1.9%, 95% CI: -3.8% to -0.0%). Decreasing trends in mortality from HCC were noted in males, not females. HCC-related mortality decreased more steeply in racial and ethnic minority individuals compared with non-Hispanic White individuals. Racial and ethnic differences in trends in mortality for biliary tract cancers depended on the malignancy's anatomical site.
While the annual mortality for HCC and gallbladder cancer demonstrated declining trends, ICC- and AVC-related mortality continued to increase from 2018 to 2023. Although racial and ethnic minority individuals in the US experienced disproportionately higher HCC and biliary tract cancer, recent declines in HCC may be primarily due to declines among racial and ethnic minority individuals and males.
背景/目的：美国肝癌（HCC）和胆道癌死亡率的性别和种族/民族趋势仍在不断演变。我们评估了美国成年人中 HCC 和胆道癌相关死亡率的性别和种族/民族趋势，重点关注疾病负担。
我们使用了 2018 年至 2023 年美国国家死亡率记录进行了一项基于人群的分析。我们使用适当的 ICD-10 代码确定 HCC 和胆道癌。死亡率的时间趋势通过每年百分比变化（APC）的 Joinpoint 分析进行计算。
HCC 的年标准化死亡率稳步下降，APC 为-1.4%（95%置信区间[CI]：-2.0%至-0.7%）。虽然肝内胆管癌相关死亡率（APC：3.1%，95%CI：1.2-4.9%）和壶腹癌相关死亡率（APC：4.1%，95%CI：0.5-7.9%）呈线性上升，但胆囊癌相关死亡率下降（APC：-1.9%，95%CI：-3.8%至-0.0%）。男性 HCC 死亡率呈下降趋势，女性则不然。与非西班牙裔白人相比，少数族裔人群的 HCC 死亡率下降更为明显。胆道癌死亡率趋势的种族和民族差异取决于恶性肿瘤的解剖部位。
虽然 HCC 和胆囊癌的年死亡率呈下降趋势，但 ICC 和 AVC 相关的死亡率从 2018 年到 2023 年仍在继续上升。尽管美国的少数族裔人群中 HCC 和胆道癌的发病率较高，但最近 HCC 的下降可能主要归因于少数族裔人群和男性的下降。
