Trends in Racial Disparities in Liver Cancer Mortality in the United States: A SEER-Based Analysis (2000–2020)

Purpose Hepatocellular carcinoma (HCC) is the most common primary liver cancer and remains a major cause of cancer mortality. Racial disparities in liver cancer mortality are substantial and have changed over time alongside changes in viral hepatitis prevention and treatment, metabolic liver disease, surveillance, and cancer care. This study aimed to characterize racial differences in incidence-based liver cancer mortality trends in the United States from 2000 to 2020. Methods A retrospective population-based trend analysis was conducted using the SEER*Stat database. Age-adjusted incidence-based mortality rates for primary liver cancer were calculated across racial groups, and temporal trends were evaluated using Joinpoint regression with annual percent change estimates. Results A total of 104,933 liver cancer deaths were included. Asian/Pacific Islander populations had the highest mortality rates early in the study period, but rates subsequently declined, whereas American Indian/Alaska Native populations experienced increasing mortality and had the highest rate by 2020. The magnitude and direction of mortality trends differed substantially across racial groups over the study period. Conclusion Racial disparities in liver cancer mortality changed substantially from 2000 to 2020, including a shift in the racial group experiencing the highest mortality burden. These findings support race-specific approaches to liver cancer prevention, surveillance, early detection, and treatment.