Primary liver cancer mortality in the United States

We analyzed time trends and regional differences in mortality from primary liver cancer in the United States in order to explore possible effects of several factors which have been suggested as causes for liver cancer. Age-adjusted liver cancer death rates have been stable over time except for nonwhite males among whom there has been a 45% increase in liver cancer mortality between 1958 and 1975. The rates for nonwhite males are twice those for white males, and geographic trends in liver cancer mortality differ by race. The rates for white males are greatest in two southern regions, whereas rates for nonwhite males in these same regions are lower than they are elsewhere. Cirrhosis mortality trends parallel those for liver cancer among nonwhite males but not among white males. The similarities in trends for cirrhosis and liver cancer mortality among nonwhite males suggest that cirrhosis may be a major risk factor in this group. For white males, we must look to some other factor to explain the geographic differences that were observed.