Disparities and Trends in Liver Cancer Incidence and Mortality Across the United States

Background Liver cancer is a growing public health concern in the United States, with increasing incidence and mortality rates over recent decades. This study investigates the age-adjusted incidence and mortality rates for liver cancer, stratified by demographic and clinical characteristics, focusing on gender, race/ethnicity, and disease staging. Methods Surveillance, Epidemiology, and End Results Program (SEER) database is used to identify the incidence and survival rates of liver cancer from 1992 to 2021. Multivariable Poisson regression using Joinpoint spline analysis was employed to estimate incidence and mortality rate ratios based on patient demographic factors Results Liver cancer incidence is notably higher in males compared to females (6.9 vs. 2.1 per 100,000). The incidence of liver cancer significantly increased among males (Annual percent change (APC) = 6.2%, 95% confidence interval (CI): 1.15–13.4, p < 0.05) and non-Hispanic Whites (APC = 8.23%, p < 0.001) while Non-Hispanic AI/AN individuals experienced a significant annual decline in incidence (-3.26%, p < 0.001). There is a significant increase in liver cancer incidence in female non-Hispanic whites (APC = 8.52, CI: 4.15, 19.1; p < 0.05). Gender disparities were evident, with females exhibiting a 72% lower incidence rate compared to males (p < 0.001). Both incidence and mortality rates increased with age, with mortality rising by 20% for every 5-year age increment (IRR = 1.20, 95% CI: 1.20–1.21; p < 0.001). Mortality rates rose significantly among females (APC = 1.51%, p < 0.001) but showed a non-significant increase in males. Conclusion Liver cancer incidence and mortality rates vary significantly by demographic and clinical characteristics, with pronounced disparities among non-Hispanic AI/AN individuals. Gender and tumor stage at diagnosis strongly influence these trends.