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Texas Has the Highest Hepatocellular Carcinoma Incidence Rates in the USA

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Abstract

Background

Texas is the second largest state by area and population in the USA and is reported to have high incidence and mortality rates for hepatocellular carcinoma (HCC). The reasons for the increasingly high burden of HCC in Texas are not clear.

Aims

We explored trends and demographic and regional variations in HCC incidence to better understand reasons for the high burden in Texas.

Methods

We analyzed Texas Cancer Registry incidence data from 2001 to 2015 and compared results to the U.S. National Program of Cancer Registries and SEER for the same period. Rates were stratified by sex, race/ethnicity, and age at diagnosis. Rates were also compared between the US/Mexico border region of Texas and the rest of Texas.

Results

Texas had the highest HCC age-adjusted incidence rate of all states, 13.2/100,000, which was 45% higher than the national average. In Texas and nationally, rates increased by 4% per year between 2001 and 2015. Rates in Texas were 26–37% greater than national rates for Hispanics, African-Americans, and non-Hispanic whites. Among Hispanics in states with the largest percentage of Hispanics, Texas-based Hispanics had the highest HCC incidence rate in 2015 (21.2/100,000) compared with Hispanics in New Mexico, California, Arizona, Nevada, and Florida. Incidence rates were highest in South Texas and US/Mexico border regions.

Conclusions

Increasing rates in the large Hispanic population may explain why Texas now has the highest HCC incidence rate in the USA.

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Abbreviations

HCC:

Hepatocellular carcinoma

HCV:

Hepatitis C virus

NAFLD:

Nonalcoholic fatty liver disease

NASH:

Nonalcoholic steatohepatitis

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Funding

This research was supported by grants from Cancer Prevention Research Institute of Texas (CPRIT) (RP150587) and National Institutes of Health (NIDDK P30DK056338) to HES. The collection of cancer incidence data used in this study was supported by the Texas Department of State Health Services and CPRIT, as part of the statewide cancer reporting program and the Centers for Disease Control and Prevention’s National Program of Cancer Registries Cooperative Agreement # #1NU58DP006308.

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Authors and Affiliations

  1. Section of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, 7200 Cambridge St., Houston, TX, 77030, USA

    Hashem B. El-Serag & Fasiha Kanwal

  2. Medical Care Line at Michael E. DeBakey VA Medical Center, Houston, TX, USA

    Hashem B. El-Serag

  3. Cancer Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, TX, USA

    Rebecca Sardell & Paige Miller

  4. Section of Epidemiology and Population Sciences, Department of Medicine, Baylor College of Medicine, Houston, TX, USA

    Aaron P. Thrift

  5. Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, USA

    Aaron P. Thrift

Authors
  1. Hashem B. El-Serag
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  2. Rebecca Sardell
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  3. Aaron P. Thrift
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  4. Fasiha Kanwal
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  5. Paige Miller
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Contributions

All authors were involved in study design and interpretation of the data and critical revision of manuscript for intellectual content. PM, RS were responsible for the acquisition of the data and statistical analyses. HES, RS, APT, and PM were responsible for drafting the manuscript. All authors read and approved the final version of the manuscript.

Corresponding author

Correspondence to Hashem B. El-Serag.

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All authors have no conflicts to disclose.

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El-Serag, H.B., Sardell, R., Thrift, A.P. et al. Texas Has the Highest Hepatocellular Carcinoma Incidence Rates in the USA. Dig Dis Sci 66, 912–916 (2021). https://doi.org/10.1007/s10620-020-06231-4

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  • DOI: https://doi.org/10.1007/s10620-020-06231-4

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