S2401 Trends and Disparities in Hepatocellular Carcinoma and Type 2 Diabetes Mellitus Mortality in the United States: A Nationwide Analysis

Introduction: Type 2 Diabetes Mellitus (T2DM) is associated with an increased risk of Hepatocellular Carcinoma (HCC) prevalence and mortality. However, the temporal and demographic patterns of HCC and T2DM mortality in the United States are not well known. With the increasing prevalence of T2DM and metabolic syndrome, analyzing mortality trends will help identify high risk populations, and guide targeted public health initiatives to improve clinical outcomes. In this study, we leveraged a large national database to analyze mortality trends from 2005 to 2020. Methods: Mortality data from the CDC WONDER database were analyzed for HCC and T2DM from 2005 to 2020 among adults aged 25 and above. Age-adjusted mortality rates (AAMRs) were calculated per 1,000,000 individuals. Annual percent change (APC) and average annual percent change (AAPC) were computed using Joinpoint regression. Trends were stratified by year, sex, race/ethnicity, urbanization status, and geographic region. Results: From 2005 to 2020, there were 5,748 HCC and T2DM related deaths among individuals aged 25 and above in the United States, with an overall AAMR of 1.5. The AAMR increased from 0.8 in 2005 to 1.2 in 2012 (APC 2.35), and to 2.5 in 2020 (APC 9.63; AAPC 6.17). Men had a higher AAMR than women (overall AAMR Male: 2.5; Female: 0.7). Both had a parallel increase from 2005 to 2020 (AAPC Male: 6.35; Female: 5.18). Hispanics had a higher AAMR than non-Hispanics (NH) (overall AAMR Hispanics 3.6; NH: 1.3). Both had a parallel increase from 2005 to 2020 (AAPC Hispanic: 5.81; NH: 6.05). Regionally, the West had the highest mortality rate (AAMR West: 2.6; Midwest: 1.5; South: 1.2; Northeast: 0.9). The West also had the highest increase in mortality from 2005 to 2020 (AAPC West: 6.64; South: 5.39; Northeast: 3.44; Midwest: 3.17). California reported the highest mortality rate (overall AAMR: 3.2). There was no difference in mortality rates between urban and rural areas (overall AAMR 1.5). Conclusion: Mortality from HCC and T2DM has increased among adults from 2005 to 2020, revealing significant sociodemographic disparities. The highest mortality rate was observed among Hispanic individuals and men, and among patients living in the West and nonmetropolitan United States. Targeted strategies are needed to improve treatment access and address modifiable risk factors.