Liver cancer incidence in the United States have begun to decline, but mortality has plateaued, according to a study published in Clinical Gastroenterology & Hepatology. These findings suggest that fewer people receiving curative therapy during the height of the COVID-19 pandemic may have had a negative impact on survival outcomes, though racial disparities have narrowed.

Over time, chronic hepatitis B, hepatitis C, heavy alcohol consumption and metabolic dysfunction-associated fatty liver disease (MASLD) can lead to serious liver complications, including cirrhosis and hepatocellular carcinoma (HCC), the most common type of liver cancer. In light of new therapeutic options for liver cancer and pandemic-era disruptions in access to diagnosis and care, an updated assessment of HCC incidence (new cases) and deaths is needed.

Ju Dong Yang, MD, of the University of California Los Angeles, and colleagues used the Surveillance, Epidemiology and End Results database to evaluate trends in HCC incidence and mortality, identifying factors linked to receiving curative therapy or no treatment and overall survival.

Liver cancer incidence rates rose from 2000 to 2014, but then leveled off from 2014 through 2019 and dropped from 2019 to 2022. Over the same period, death rates among people with liver cancer rose until 2013, but thereafter stabilized through 2022. 

When compared to the 2016-2019 period, people who were diagnosed with HCC between 2020 and 2022 were less likely to receive curative therapy—and more likely to not receive any treatment at all.

Overall survival gradually improved from 2000 through 2019, but gains plateaued during the height of the pandemic. However, survival outcomes did improve overall for particular groups, including people younger than 50, Black people and those with advanced liver cancer.

“The reduced survival disparities between non-Hispanic Black and White patients may reflect improved equitable medical access,” the study authors suggested.

“HCC incidence rates have started to decline, and incidence-based mortality has plateaued,” the researchers wrote. “Given lower early-stage detection and curative treatments during the COVID-19 pandemic, longer-term follow-up is warranted to assess the impact on survival.”

Click here for more news about liver cancer.