Trends in liver cancer mortality in the United States (2010–2021): A call for focused public health strategies.

e22534 Background: Liver cancer is the third leading cause of cancer-related mortality globally, contributing to 4.6% of all cancer deaths in the United States in 2022. Despite advancements in hepatitis treatment and early detection of liver cancer, its mortality has risen. This study evaluates mortality trends from 2010 to 2021 in the US, analyzing etiological contributions to identify intervention targets. Methods: Using the Global Burden of Disease 2021 database, a retrospective cohort analysis was conducted to examine annual liver cancer deaths by specific causes from 2010-2021. Joinpoint regression analysis identified shifts in mortality trends, with statistical significance of P<0.05. Results: From 2010–2021, liver cancer mortality in the U.S. increased at an average annual growth rate (AAGR) of 3.9%, with the highest rise of 7.1% recorded in 2015–2016. Hepatitis C and alcohol use were the leading contributors, accounting for 39.7% and 29.9% of liver cancer deaths in 2021, respectively. Liver cancer deaths rose by 32.14% (4.7% AAGR) from 2010–2016 but slowed to 15.81% (2.98% AAGR) from 2016–2021 (P=0.0082). Mortality from hepatitis C followed a similar trajectory, increasing by 32.77% (4.84% AAGR) from 2010–2016 but slowing to 15.15% (2.86% AAGR) from 2016–2021 (P=0.0195). Hepatitis B-related mortality declined significantly, from 24.72% (3.75% AAGR) in 2010–2016 to 7.12% (1.38% AAGR) in 2016–2021 (P=0.0001). Alcohol-related deaths rose by 34.52% (5.07% AAGR) from 2010–2016, tapering to 20.01% (3.72% AAGR) from 2016–2021 (P=0.0122). Deaths attributed to non-alcoholic steatohepatitis (NASH) increased by 26.64% (8.19% AAGR) from 2010–2013, followed by slower growth of 24.80% (2.81% AAGR) from 2013–2021 (P=0.1178). Although statistically insignificant, this slowing trend may reflect rising obesity and metabolic syndrome rates. Mortality from other causes rose by 25.16% (3.81% AAGR) in 2010–2016 and by 19.03% (3.55% AAGR) in 2016–2021 (P=0.0059). Conclusions: While the slowing of hepatitis-related mortality highlights the success of targeted interventions for hepatitis in the US, persistently high alcohol and NASH-related liver cancer deaths underscore the urgent need for focused prevention strategies in addressing modifiable risk factors like alcohol consumption, obesity and metabolic disorders. Liver cancer mortality trends by cause (2010-2021). Cause Trend Segments Average Annual Growth Rate P-value Liver cancer 2010-162016-21 32.14% (4.7%)15.81% (2.98%) 0.0082 Hepatitis C-related 2010-162016-21 32.77% (4.84%)15.15% (2.86%) 0.0195 Hepatitis B-related 2010-162016-21 24.72% (3.75%)7.12% (1.38%) 0.0001 Alcohol-related 2010-162016-21 34.52% (5.07%)20.01% (3.72%) 0.0122 NASH-related 2010-132013-21 26.64% (8.19%)24.80% (2.81%) 0.1178 Other causes 2010-162016-21 25.16% (3.81%), 19.03% (3.55%) 0.0059