Rural-Urban Disparities in Hepatocellular Carcinoma Incidence and Mortality

Area of Science:

• Oncology
• Public Health
• Epidemiology

Background:

• Hepatocellular carcinoma (HCC) incidence has declined nationally in the US.
• Trends in HCC incidence among rural populations remain unclear.
• Understanding rural-urban disparities is crucial for public health initiatives.

Purpose of the Study:

• To examine rural-urban differences in HCC incidence and incidence-based mortality trends.
• To analyze these trends by sex, race, ethnicity, and stage at diagnosis.
• To inform targeted interventions for rural populations.

Main Methods:

• A cohort study analyzed HCC diagnoses (2001-2022) and deaths (2007-2022) from national cancer registries.
• Rurality was classified using the 2013 Rural-Urban Continuum Codes.
• Joinpoint regression estimated annual percentage changes in incidence and mortality rates.

Main Results:

• HCC incidence increased in rural counties (+1.1% annually for men, +1.7% for women) but decreased in urban counties (-1.4% for men, -1.0% for women).
• Incidence-based mortality rates increased in rural men (+1.2% annually) and remained stable in rural women.
• Urban mortality rates decreased for both men (-1.4% annually) and women (-1.0% annually).

Conclusions:

• Significant rural-urban disparities exist in HCC incidence and mortality trends.
• Rural populations, especially men, face increasing HCC incidence and mortality.
• Targeted prevention, early detection, and improved access to care are essential for rural residents.