• As Incidence and Deaths from Other Cancers Decrease, Liver Cancer Increases in US

As Incidence and Deaths from Other Cancers Decrease, Liver Cancer Increases in US

Deaths from almost all cancers in the United States decreased from 1975 to 2012—except for liver cancer.

In the Annual Report to the Nation on the Status of Cancer, 1975–2012, published online by the National Cancer Institute, A. Blythe Ryerson et al report that the overall cancer death rates for men and women of all major racial and ethnic populations decreased by 1.5% per year from 2003 to 2012.

Age-adjusted incidence rates for 2008 to 2012 of liver and intrahepatic bile duct cancer by state for areas in the US with high-quality incidence data. Rates are per 100,000 persons and were age-adjusted to the 2000 US standard population.

Age-adjusted incidence rates for 2008 to 2012 of liver and intrahepatic bile duct cancer by state for areas in the US with high-quality incidence data. Rates are per 100,000 persons and were age-adjusted to the 2000 US standard population.

Cancer incidence data were obtained from the CDC, NCI, and NAACCR. Data on cancer deaths were obtained from the CDC’s National Center for Health Statistics. Annual percent changes in incidence and death rates (age-adjusted to the 2000 US Standard Population) for all cancers combined and for the leading cancers among men and women were estimated by Joinpoint analysis of long-term trends (incidence for 1992–2012 and mortality for 1975–2012) and short-term trends (2008–2012).

Medscape explained that incidence rates (new cancer cases diagnosed per 100,000 people) decreased among men and remained stable among women during that period.

Among men, overall rates of cancer death decreased by an average of 1.8% per year. Among women, they decreased by an average of 1.4% per year. For children and adolescents aged 0 to 19 years, they decreased by an average of 2% per year.

In a summary of the report, the NCI explained that from 2003 through 2012, 7 of the 17 more common cancers in men showed decreases in incidence (colorectal, lung and bronchus, prostate, stomach, larynx, bladder, and brain cancers). Six of the 18 more common cancers in women showed decreases in incidence (cancers of the colorectum, cervix, lung and bronchus, bladder, ovary, and stomach). Overall cancer incidence rates for all persons combined decreased on average 0.7% per year.

However, deaths from liver cancer went against this trend. Ryerson et al state that in men and women, deaths from liver cancer increased at the highest rate of all cancer sites. Deaths from liver cancer in 2012 were almost 2-fold greater in men than in women (15,563 in men vs 7409 in women). Liver cancer-related deaths increased 2.8% per year in men and 2.2% per year in women from 2003 to 2012. Hepatitis C virus (HCV)- and liver cancer-associated death were greatest among individuals born from 1945 through 1965.

The incidence of liver cancer also increased sharply, second only to thyroid cancer.

Men had more than twice the incidence rate of liver cancer than women, and rates increased with age for both sexes. Among non-Hispanic white or black, and Hispanic men and women, liver cancer incidence rates were higher for persons born after the 1938 to 1947 birth cohort. In contrast, there was a minimal birth cohort effect for non-Hispanic Asian and Pacific Islanders. Non-Hispanic black men and Hispanic men had the lowest median age at death (60 and 62 years, respectively) and the highest average person-years of life lost per death (21 and 20 years, respectively) from liver cancer.

Liver cancer incidence rates were highest in Pacific states, in states on the southern US border, in the District of Columbia, and in a few states in the Northeast (Delaware, Connecticut, Massachusetts, and New York; see figure).

During the period 2008 to 2012, the incident rate of liver cancer was nearly 3-fold higher in men than in women. For men, the incidence rate was 11.5%, and for women, it was 3.9%.

In 2012, the most recent year for which data are available, 28,012 people were diagnosed with liver cancer in the United States. Of these, 20,207 were men, and 7805 were women.

Ryerson et al conclude that the burden of liver cancer is growing and is not equally distributed throughout the population. Efforts to vaccinate populations that are vulnerable to hepatitis B virus (HBV) infection, as well as identify and treat people with HBV or HCV infection, metabolic conditions, alcoholic liver disease, or other causes of cirrhosis, might reduce the incidence and mortality of liver cancer.

In addition to liver cancer, rates of death also increased among men for cancers of soft tissue, including heart (1.1% per year), and pancreas (0.3% per year). In women, deaths increased from cancers of the liver (2.2% per year), uterus (1.1% per year), and pancreas (0.4% per year).

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