title: Changing hepatocellular carcinoma incidence and liver cancer mortality rates in the United States.
abstract: OBJECTIVE
  The objectives were to describe Surveillance, Epidemiology and End Results (SEER) hepatocellular carcinoma (HCC) incidence trends and the US liver cancer mortality trends by geography, age, race/ethnicity, and gender.
  
  
  METHODS
  HCC incidence data from SEER 18 registries and liver cancer mortality data from the National Center for Health Statistics were analyzed. Rates and joinpoint trends were calculated by demographic subgroup. State-level liver cancer mortality rates and trends were mapped.
  
  
  RESULTS
  HCC incidence rates in SEER registries did not significantly increase during 2007-2010; however, the US liver cancer mortality rates did increase. HCC incidence and liver cancer mortality rates increased among black, Hispanic, and white men aged 50+ years and decreased among 35-49-year-old men in all racial/ethnic groups including Asians/Pacific Islanders. Significantly increasing incidence and mortality rates among women were restricted to blacks, Hispanics, and whites aged 50+ years. Asian/Pacific Islander liver cancer mortality rates decreased during 2000-2010 with decreasing rates among women aged 50-64 years and men aged 35-49 years and stable rates in other groups. During 2006-2010, among individuals 50-64 years of age, blacks and Hispanics had higher incidence and mortality rates than Asians/Pacific Islanders. Liver cancer mortality rates were highest in Louisiana, Mississippi, Texas, and Washington, DC.
  
  
  CONCLUSIONS
  Decreasing HCC incidence and liver cancer mortality rates among Asians/Pacific Islanders, men aged 35-49 years, and the nonsignificant increase in overall HCC incidence rates suggest that the peak of the epidemic may be near or have passed. Findings of geographic variation in mortality rates can inform control efforts.
authors: Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland, USA.
authors: Sean F
authors: SF
authors: Altekruse
authors: Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors: S Jane
authors: SJ
authors: Henley
authors: Information Management Services, Silver Spring, Maryland, USA.
authors: James E
authors: JE
authors: Cucinelli
authors: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA.
authors: Katherine A
authors: KA
authors: McGlynn
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology* / Q000208:ethnology / Q000401:mortality; D005260:Female; D006801:Humans; D015994:Incidence; D008113:Liver Neoplasms / Q000453:epidemiology / Q000208:ethnology / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D018426:SEER Program; D017678:Sex Distribution; D014481:United States / Q000453:epidemiology