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Hepatitis C virus-related hepatocellular carcinoma mortality: a focus on the US-Mexico border region
Merry Mathew1, Michelle Nguyen1, Ketan Jolly1
1School of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA.
Insights
Hepatocellular carcinoma (HCC) mortality linked to hepatitis C virus (HCV) is higher in the US-Mexico border region. This disparity is most pronounced among Black and American Indian/Alaska Native populations.
Area of Science:
- Public Health
- Hepatology
- Epidemiology
Background:
- Hepatocellular carcinoma (HCC) mortality rates are notably high in the US-Mexico border region.
- Significant disparities exist in hepatitis C virus (HCV)-related HCC mortality between border and nonborder areas.
Purpose of the Study:
- To investigate and compare HCV-related HCC mortality rates between the US-Mexico border region and nonborder regions.
- To identify ethnic and geographic disparities in HCV-related HCC mortality.
Main Methods:
- Utilized the CDC WONDER Multiple Cause of Death database (2000-2020).
- Analyzed deaths coded for chronic HCV (ICD-10 B18.2) and HCC (ICD-10 C22.0).
- Calculated and compared age-standardized mortality rates (ASMRs) between border and nonborder regions, with significance determined by nonoverlapping 95% confidence intervals.
Main Results:
- The border region exhibited a 1.6-fold higher ASMR for HCV-related HCC compared to nonborder regions (0.8 vs. 0.5 per 100,000).
- All ethnic groups in the border region showed higher ASMRs than their nonborder counterparts.
- Within the border region, Black individuals faced the highest risk (RR=2.0), followed by American Indian (RR=1.9) and White (RR=2.0) populations compared to their nonborder counterparts. Hispanic individuals also showed increased risk (RR=1.3).
Conclusions:
- HCV-related HCC mortality is significantly elevated in the US-Mexico border region.
- Ethnic disparities in mortality are pronounced, with Black and American Indian/Alaska Native populations experiencing disproportionately higher rates within the border region.
Background:
In the United States, hepatocellular carcinoma (HCC) mortality is disproportionately high in the US-Mexico border region. This study examined disparities in hepatitis C virus (HCV)-related HCC mortality between border and nonborder regions.
Methods:
We queried the CDC WONDER Multiple Cause of Death database from 2000 to 2020 for deaths with ICD-10 codes B18.2 (chronic HCV) and C22.0 (HCC). Age-standardized mortality rates (ASMRs) per 100,000 were compared across border and nonborder regions. Significant differences were determined by nonoverlapping 95% confidence intervals.
Results:
The border region had a 1.6-fold higher overall ASMR (95% CI = 1.5-1.7) than nonborder regions (0.8 vs 0.5 per 100,000). All ethnic groups in the border region had a higher ASMR than their nonborder counterparts, with pronounced risk ratios (RR) in White (RR = 2.0, 95% CI = 1.9-2.1), American Indian (RR = 1.9, 95% CI = 1.2-2.8), and Black/African American (RR = 1.6, 95% CI = 1.3-2.0) people. Within the border region, Black people had the highest risk compared to White people (RR = 2.0, 95% CI = 1.6-2.6), followed by American Indian people (RR = 1.6, 95% CI = 1.1-2.5). Hispanic people also had an increased risk (RR = 1.3, 95% CI = 1.2-1.4) compared to non-Hispanic people.
Conclusion:
HCV-related HCC mortality is significantly higher in the US-Mexico border region, particularly among Black and American Indian/Alaska Native populations.
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