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Disparity in ethnicity, sex persists with increasing liver cancer rates

Liver cancer mortality rates resulting from cirrhosis are increasing and in the coming decades will become a leading cause of death.  Liver cancer has increaesed 300% since 1980 in step with the obesity and fatty liver disease epidemics. It is currently the 5th most common cancer in men and the 8th in women but increasing rapidly in both sexes.

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“Liver cancer death rates are increasing at a faster pace than any other cancer. A major factor contributing to this increase is the comparatively high prevalence of hepatitis C virus (HCV) infection among those born during 1945 through 1965, also called ‘baby boomers.’ The sustained rise in obesity and type 2 diabetes over the past several decades has also likely contributed to the increasing liver cancer trend,” Farhad Islami, MD, PhD, from the American Cancer Society, Georgia, and colleagues wrote. “The incidence of liver cancer varies by race/ethnicity and state, mainly because of differences in the prevalence of major risk factors and, to some degree, because of disparities in access to high-quality care.”

These are among the reasons that we are developing our mobile liver van. Many at risk people never have an opportunity to be evaluated for fatty liver disease and the problem is worse for women and ethnicities.  By taking our service directly to the people we can do our small part to reduce these problems

According to data available since 1992 for incidence rates and 1990 for mortality rates, American Indians and Alaskan Natives experienced the highest increase in incidence (15.2 per 100,000) and mortality rates (11.9 per 100,000), compared with the lowest rates seen in Caucasians (6.3 and 5.5 per 100,000, respectively). However, incidence rates did not appear to increase after 2009 among American Indians and Alaskan Natives.

Mortality rates rose by 57% in African-Americans and 69% in Hispanics. Among African-Americans, mortality rates peaked at age 60 to 64 years, compared with 80 to 84 years in all other racial or ethnic groups. Mortality rates were two- to threefold higher among men of all racial or ethnic groups compared with women at both a national and state level.

African-American men had a significantly higher mortality rate compared with Caucasian men in all states except Mississippi, New Mexico, Arkansas and South Carolina, with the highest disparity found in the District of Columbia (fourfold higher).

According to the researchers, approximately 60% of liver cancer cases in the U.S. are attributed to potentially modifiable risk factors, though the proportions vary due to different data sources.

Although the populations with particularly high infection prevalence such as regular drug users and homeless people are underrepresented in most data sources, the researchers found that the overall proportion of hepatocellular carcinoma cases from 2000 to 2011 attributable to HCV was 17% for Caucasians, 21% for Hispanics, 30% for Asians and 36% for African-Americans.