Pan Chun-Wei, Danpanichkul Pojaskorn, Cheung Ramsey, Pinheiro Paulo, Jones Patricia D, Wong Robert J
Department of Internal Medicine, John H. Stroger Hospital of Cook County, Chicago, IL.
Department of Internal Medicine, Texas Tech Health Sciences Center, Lubbock, TX.
J Clin Gastroenterol. 2025 Jun 23. doi: 10.1097/MCG.0000000000002162.
Hepatocellular carcinoma (HCC) is a growing public health concern in the United States. While socioeconomic factors have been linked to HCC outcomes, the impact of urban-rural residence remains understudied. This analysis examines trends in HCC mortality between urban and rural areas from 1999 to 2020.
Using the "Centers for Disease Control and Prevention Wide Ranging Online Data for Epidemiologic Research" database, we analyzed age-adjusted HCC mortality rates in urban and rural counties. Joinpoint regression was used to calculate annual percentage change and average annual percentage change (AAPC) in mortality rates. We examined trends by demographics and geographic regions.
Overall HCC mortality increased from 1999 to 2020 (AAPC: 1.24%). Rural areas experienced a more rapid rise (AAPC: 1.97%) in HCC mortality compared with urban areas (AAPC: 1.11%), and in 2020 HCC mortality in rural areas surpassed that in urban areas. Significant disparities in HCC mortality were also observed by other sociodemographic factors, with the highest HCC mortality among men, older adults, and ethnic minority populations in rural regions.
Significant disparities in HCC mortality were observed by urban-rural geography in the United States, which seems to be exacerbated by underlying sociodemographic factors. Better understanding of potential modifiable drivers of these disparities will help guide interventions to improve long-term patient outcomes.
肝细胞癌（HCC）在美国正日益引起公众健康关注。虽然社会经济因素与HCC的预后相关，但城乡居住情况的影响仍未得到充分研究。本分析考察了1999年至2020年城乡地区HCC死亡率的趋势。
利用“疾病控制与预防中心广泛的流行病学研究在线数据”数据库，我们分析了城乡县调整年龄后的HCC死亡率。采用Joinpoint回归计算死亡率的年度百分比变化和平均年度百分比变化（AAPC）。我们按人口统计学和地理区域考察了趋势。
1999年至2020年期间，总体HCC死亡率上升（AAPC：1.24%）。与城市地区（AAPC：1.11%）相比，农村地区HCC死亡率上升更快（AAPC：1.97%），且在2020年农村地区的HCC死亡率超过了城市地区。在其他社会人口学因素方面也观察到HCC死亡率存在显著差异，农村地区男性、老年人和少数民族人群的HCC死亡率最高。
在美国，城乡地域在HCC死亡率方面存在显著差异，而潜在的社会人口学因素似乎加剧了这种差异。更好地了解这些差异的潜在可改变驱动因素将有助于指导干预措施，以改善患者的长期预后。
