Epidemiology and Disparities in Hepatocellular Carcinoma

Hepatocellular carcinoma (HCC) is the most common primary malignancy of the liver, accounting for the majority of liver cancer cases worldwide. Incidence and mortality rates vary markedly by region, reflecting underlying aetiological factors such as chronic infection with hepatitis B and C viruses, exposure to aflatoxin in certain regions, and the growing burden of metabolic liver disease linked to obesity and diabetes. Historically, East Asia and sub-Saharan Africa have exhibited the highest rates, driven in large part by vertical transmission of hepatitis B virus and limited access to vaccination. In Western Europe and North America, the incidence of HCC is rising, driven by ageing cohorts of hepatitis C virus infection and the epidemic of non-alcoholic fatty liver disease. Within nations, substantial disparities exist by race, ethnicity, socioeconomic status and geography. Men are affected at two to three times the rate of women, and outcomes are poorer in minoritised populations who experience barriers to screening, early detection and curative treatment. Socioeconomic deprivation compounds risk through delayed presentation and limited access to specialised care. Small-area analyses reveal heterogeneity of mortality even within high-income countries, underscoring the need for tailored public health strategies. As antiviral therapies and metabolic interventions improve, the epidemiological landscape is shifting, but entrenched inequalities in prevention, surveillance and treatment continue to amplify the burden in vulnerable groups.

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Epidemiology and Disparities in Hepatocellular Carcinoma publication trend

The graph below shows the total number of articles in epidemiology and disparities in hepatocellular carcinoma across all publications each year (not limited to Nature Index journals).

Technical terms

Hepatocellular carcinoma (HCC): A primary malignancy of the liver arising from hepatocytes, often in the context of chronic liver disease.

Age-standardised rate: An incidence or mortality rate adjusted to a standard age distribution, enabling comparison across populations with different age structures.

Socioeconomic status (SES): A composite measure of an individual’s or group’s economic and social position, typically based on income, education and occupation.

Non-alcoholic fatty liver disease (NAFLD): A spectrum of liver conditions characterised by excess fat accumulation in the liver in the absence of significant alcohol consumption, increasingly implicated in HCC risk.

References

1. Burden of liver cancer mortality by county, race, and ethnicity in the USA, 2000–19: a systematic analysis of health disparities. The Lancet Public Health (2024).
2. Addressing racial and ethnic disparities in US liver cancer care. Hepatology Communications (2023).
3. Disparities in Hepatocellular Carcinoma Incidence, Stage, and Survival: A Large Population-Based StudyDisparities in Hepatocellular Carcinoma. Cancer Epidemiology Biomarkers & Prevention (2021).