S2336 Racial and Gender Disparities in Cancer and Liver Fibrosis/Cirrhosis Mortality Among US Adults: Insights From CDC WONDER (1999-2020)

Introduction: Hepatocellular carcinoma and cirrhosis cause over 50,000 deaths annually in the U.S., with mortality rates revealing persistent and widening disparities by gender and race. Analyzing 20 years of CDC data, this study uncovers distinct mortality patterns driven by complex biological and social factors, underscoring an urgent need for targeted public health strategies to address these inequities and improve liver disease outcomes. Methods: We performed a retrospective analysis using the CDC WONDER database to examine adults aged ≥20 years who died from liver cancer or cirrhosis (International Classification of Diseases, Tenth Revision [ICD-10]: C22, K70, K74) from 1999 to 2020. Annual age-adjusted mortality rates per 100,000 population were calculated and stratified by gender and race to characterize demographic disparities. Joinpoint regression was applied to identify statistically significant changes in mortality trends, with significance set at P < 0.05. Results: Female mortality rates were stable until 2009, then rose sharply by 4.13% annually, narrowing but not closing the gap with men, whose rates increased steadily by 2.79% per year and remained over twice as high by 2020 (4.63 vs 2.06 per 100,000). Racial disparities were striking: American Indian/Alaska Native populations had the highest mortality in 2020 (5.01), rising 2.47% annually since 1999. Black mortality surged 4.57% annually from 2003 to 2013 before plateauing. Hispanic/Latino and White populations experienced steady increases after 2007 and 2003 (2.23% and 3.85% annually), reaching 4.77 and 3.31 per 100,000, respectively. Asian/Pacific Islanders had the lowest and most stable rates, rising modestly by 0.87% annually to 2.65. Conclusion: Female mortality was stable until 2009, then rose 4.13% annually, narrowing but not closing the gap with men, whose rates grew 2.79% annually and remained over twice as high by 2020 (4.63 vs 2.06 per 100,000). American Indian/Alaska Native mortality was highest in 2020 (5.01), rising 2.47% annually since 1999. Black rates surged 4.57% annually from 2003–2013 before plateauing. Hispanic/Latino and White mortality increased steadily (2.23% and 3.85% annually) to 4.77 and 3.31, while Asian/Pacific Islanders had the lowest, most stable rates, rising 0.87% to 2.65.