Decline in Hepatocellular Carcinoma and Evolving Age at Diagnosis in a Primarily African American Medical Center Population

Introduction: Hepatocellular carcinoma (HCC) remains a significant global health burden, particularly among vulnerable populations. This study investigates trends in HCC incidence and age at diagnosis within an urban medical center population, focusing on the impact of hepatitis C virus (HCV) treatment and racial disparities. Methods: A retrospective cohort analysis was conducted using a merged dataset of 484 patients diagnosed with HCC between 2000 and 2023. Demographic, clinical, and laboratory data were collected and analyzed to assess trends in HCC incidence, age at diagnosis, and associated risk factors. Results: A significant decline in HCC incidence was observed with a peak in incidences between 2015 and 2017 (p<0.02). The increase and subsequent decline was primarily driven by a shift in HCV-related cases, particularly among the African American (AA) population. This trend was not seen for patients with other risk factors for HCC. There was an increase in age of AA patients at the time of diagnosis (62 years early vs 69 years recent p= 0.001) but not non-AA patients (66 years early vs 67 years recent p=0.16). Possibilities to account for this include variations in an aging population, changing risk factor profiles, and/or limitations in surveillance and early detection of HCC. Conclusion: This study highlights the critical role of HCV treatment in reducing HCC incidence, particularly within the AA population. These findings emphasize the need for sustained efforts in surveillance, early detection, and targeted prevention strategies to address the evolving epidemiology of HCC and improve outcomes across all populations.