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Published on: September 30, 2021
Mortality from hepatocellular and biliary cancers: changing epidemiological trends
Satheesh Nair1, K Shiv Kumar, Paul J Thuluvath
1Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Insights
Hepatocellular carcinoma (HCC) and biliary cancer (BC) mortality rose in Maryland over 30 years. HCC deaths doubled in men and increased significantly in white Americans, while BC deaths rose modestly overall but sharply in African Americans.
Area of Science:
- Epidemiology
- Oncology
- Public Health
Background:
- Hepatocellular carcinoma (HCC) incidence may be increasing in the US.
- Biliary cancers (BCs) encompass gallbladder and bile duct malignancies.
Purpose of the Study:
- To analyze epidemiological trends in mortality for HCC and BCs in Maryland over three decades (1970-1997).
Main Methods:
- Utilized vital statistics data from Maryland State Department of Health & Hygiene (1970-1997).
- Grouped gallbladder, intrahepatic, and extrahepatic bile duct cancers as BCs.
- Analyzed mortality trends across seven 4-year periods.
Main Results:
- Mortality from HCC increased from 0.94 to 1.84 per 100,000 (RR=1.94), and BCs from 1.28 to 1.7 per 100,000 (RR=1.31).
- HCC mortality doubled in men and increased modestly in women.
- HCC mortality disparities between white Americans and African Americans decreased due to increased white American deaths; BC deaths rose significantly among African Americans.
Conclusions:
- Maryland experienced a marked increase in HCC deaths over three decades, particularly among men and white Americans.
- BC deaths showed a modest overall increase, but a significant rise among African Americans warrants further investigation.
- Trends suggest a growing burden of liver and biliary cancers in the studied population.
Objectives:
The incidence of hepatocellular carcinoma may be rising in the United States. The aim of this study was to determine the epidemiological trends in mortality from hepatocellular carcinoma (HCC) and biliary cancers (BCs) in Maryland during the last 3 decades.
Methods:
The number of deaths due to HCC and BCs from 1970 to 1997 were obtained from the Maryland State Department of Health & Hygiene vital statistics database. Malignant neoplasms of the gallbladder and intrahepatic and extrahepatic bile ducts were grouped together as biliary cancers. To determine the trend in mortality, the total time period was divided into seven 4-yr periods.
Results:
Mortality from HCC increased from 0.94 to 1.84 per 100,000 population (rate ratio = 1.94, CI = 1.87-2.03) and that from BCs increased from 1.28 to 1.7 per 100,000 population (rate ratio = 1.31, CI = 1.26-1.36) over the study period. Although mortality due to HCC doubled in men (1.34 to 2.7 per 100,000) during this period, only a modest increase was observed among women (0.59 to 1.06 per 100,000). Because of a marked increase in the number of deaths among white Americans, the difference in HCC-related mortality between white Americans and African Americans decreased considerably during this period. Mean age at death increased steadily for BCs from 67 to 73 yr, whereas there was no real trend for HCC. Among African Americans, the death from HCC remained stable, but there was a 2-fold increase in BC-related death.
Conclusions:
There was a marked increase in deaths from HCC over the past 3 decades in Maryland. This increase was more evident among men and white Americans. Deaths due to BCs increased modestly during the same period of observation. The marked rise in BC-related deaths among African Americans remains unexplained.
