Disparities in Hepatocellular Carcinoma Incidence in California: An Update

Cancer Epidemiol Biomarkers Prev. 2020 Jan;29(1):79-87. doi: 10.1158/1055-9965.EPI-19-0560. Epub 2019 Nov 12.


Background: Given changes in hepatocellular carcinoma (HCC) incidence and the ethnodemographic landscape, we analyzed recent HCC incidence patterns and trends in California.

Methods: Using 47,992 primary, invasive HCC cases diagnosed from 1988 to 2014 from the California Cancer Registry, we calculated age-adjusted incidence rates (IR), annual percent change (APC), and 95% confidence intervals (CI) by sex, race/ethnicity, and nativity among Hispanics and Asian ethnic groups.

Results: Compared with non-Hispanic Whites (NHW), all other racial/ethnic groups had higher HCC incidence. Vietnamese had the highest IRs (males: 47.4, 95% CI, 45.3-49.5; females: 14.1, 95% CI, 13.0-15.3). Foreign-born Chinese, Japanese, Korean, and Vietnamese had higher incidence than U.S.-born. The reverse was observed for Hispanic males, whereas no differences by nativity were seen for Hispanic females. IRs increased most for NHWs. Among Asians, male and female Filipinos and Japanese males experienced rate increases, whereas male and female Koreans and Chinese males experienced rate decreases. U.S.-born male and female Hispanics and Japanese had higher APCs than foreign-born, as did Filipino males, whereas Chinese males had a reverse pattern. Annual increases in HCC incidence slowed down in recent years for U.S.-born Hispanic males and females and stabilized among male NHWs and non-Hispanic Blacks. For some Asian groups, early time periods exhibited increasing/stable APCs, whereas later time periods showed decreasing APCs.

Conclusions: We found significant racial/ethnic and nativity differences in HCC IRs and trends.

Impact: With changing trends, closer surveillance of HCC incidence by disaggregated race/ethnicity and nativity is warranted among Hispanics and Asians.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Asian / statistics & numerical data*
  • California / epidemiology
  • Carcinoma, Hepatocellular / epidemiology*
  • Cohort Studies
  • Female
  • Health Status Disparities*
  • Hispanic or Latino / statistics & numerical data*
  • Humans
  • Incidence
  • Liver Neoplasms / epidemiology*
  • Male
  • Middle Aged
  • SEER Program / statistics & numerical data
  • Sex Factors