S2732 Trends and Disparities in Hepatocellular Carcinoma Mortality Among Patients Aged 40 and Older in Texas: A Two-Decade Retrospective Study Using CDC WONDER Data

Introduction: Hepatocellular carcinoma (HCC) is on the rise due to increased incidence of cirrhosis in the U.S., more precisely in Texas due to multiple factors. HCC is one of the lethal complications of liver cirrhosis and is associated with high mortality and morbidity. This study aims to analyze mortality trends in HCC among patients older than 40 years in the state of Texas. Methods: A study was conducted using CDC Wonder database by using International Classification of Diseases, Tenth Revision (ICD-10) codes for Hepatocellular carcinoma (C22.0). People older than 40+ years old were included in the study. Analysis was done to calculate the crude rate per 100,000 people. APC was calculated using Joint point software to estimate trends by calendar year, Sex, race, ethnicity and geographical area. Results: From 1999 to 2020, a total of 17,008 patients died of HCC in Texas, with a continuous upward trend (APC: 2.74). Of these, 13,004 were men, and the remainder were women. Men had a consistent annual increase (APC: 2.95), while women initially showed a decline (APC: –2.49), followed by a rising trend (APC: 3.64) from 2006 to 2020. Among racial groups, Asian or Pacific Islanders showed a significant annual decrease (APC: –2.7, P = 0.000017). Black or African American individuals had a significant increase (APC: 2.82, P = 0.000008). White individuals showed a notable annual increase (APC: 4.73) from 2007 to 2018, with no significant changes before or after this period. Disparities were also observed between Hispanics and non-Hispanic individuals. Hispanics experienced a continuous rise in mortality with an annual increase of 1.28. Non-Hispanic individuals initially had a non-significant declining trend, followed by a consistent increase (APC: 2.06) from 2010 to 2020. Geographically, all large metro and non-metro areas showed a continuous upward trend, with higher annual increases observed in smaller towns with APC 4.97% increased annually since 1999. Conclusion: Our study observed a continuous increase in HCC mortality in Texas. Since 2006, women have shown a greater rise in mortality compared to men. Hispanic/Latino populations are also experiencing a consistent upward trend. These findings highlight the importance of appropriate HCC screening in all patients with liver cirrhosis, which may help reduce both incidence and mortality.