title: Hepatocellular carcinoma incidence, mortality, and survival trends in the United States from 1975 to 2005.
abstract: OBJECTIVE
  Hepatocellular carcinoma (HCC) is the third leading cause of cancer mortality worldwide. Incidence rates are increasing in the United States. Monitoring incidence, survival, and mortality rates within at-risk populations can facilitate control efforts.
  
  
  METHODS
  Age-adjusted incidence trends for HCC were examined in the Surveillance, Epidemiology, and End Results (SEER) registries from 1975 to 2005. Age-specific rates were examined for birth cohorts born between 1900 and 1959. Age-adjusted incidence and cause-specific survival rates from 1992 to 2005 were examined in the SEER 13 registries by race/ethnicity, stage, and treatment. United States liver cancer mortality rates were also examined.
  
  
  RESULTS
  Age-adjusted HCC incidence rates tripled between 1975 and 2005. Incidence rates increased in each 10-year birth cohort from 1900 through the 1950s. Asians/Pacific Islanders had higher incidence and mortality rates than other racial/ethnic groups, but experienced a significant decrease in mortality rates over time. From 2000 to 2005, marked increases in incidence rates occurred among Hispanic, black, and white middle-aged men. Between 1992 and 2004, 2- to 4-year HCC survival rates doubled, as more patients were diagnosed with localized and regional HCC and prognosis improved, particularly for patients with reported treatment. Recent 1-year survival rates remained, however, less than 50%.
  
  
  CONCLUSIONS
  HCC incidence and mortality rates continue to increase, particularly among middle-aged black, Hispanic, and white men. Screening of at-risk groups and treatment of localized-stage tumors may contribute to increasing HCC survival rates in the United States. More progress is needed.
authors.affiliation: Division of Cancer Control and Population Sciences, and the Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD 20892-8316, USA. altekrusesf@mail.nih.gov
authors.forename: Sean F
authors.initials: SF
authors.lastname: Altekruse
authors.forename: Katherine A
authors.initials: KA
authors.lastname: McGlynn
authors.forename: Marsha E
authors.initials: ME
authors.lastname: Reichman
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology* / Q000208:ethnology / Q000401:mortality; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008113:Liver Neoplasms / Q000453:epidemiology* / Q000208:ethnology / Q000401:mortality; D008297:Male; D008875:Middle Aged; D018426:SEER Program; D012737:Sex Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult