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Hashem B. El-Serag, MD, MPH; Melvin Lau, MD; Karl Eschbach, PhD; Jessica Davila, PhD; James Goodwin, MD

Arch Intern Med. 2007;167(18):1983-1989.

Background  To our knowledge, no detailed analysis exists of the incidence and mortality of hepatocellular carcinoma (HCC) among Hispanics in the United States. In previous studies, the rates for Hispanics have not been reported separately from other racial or ethnic groups.

Methods  We used information on patients diagnosed as having HCC from 13 registries in the Surveillance Epidemiology and End Results (SEER) database of the National Cancer Institute to calculate race-specific, age-adjusted incidence rates (AIR) between 1992 and 2002. We also used California and Texas state death records from between 1979 and 2001 to calculate race-specific, age-adjusted mortality rates for liver cancer excluding intrahepatic cholangiocarcinoma. For Hispanics and Asians/Pacific Islanders, the rates were calculated for native-born subjects and immigrants separately.

Results  In SEER, the yearly AIRs were higher by 1.2-fold in Hispanics than in blacks (6.3 vs 5.0 per 100 000 person-years of the underlying US population) and by 2.7-fold than in non-Hispanic whites (2.4 per 100 000 person-years) but lower than in Asians/Pacific Islanders (10.8 per 100 000 person-years). The median age at HCC diagnosis in Hispanics (64 years) was intermediate between whites (the oldest) and blacks (the youngest). Between the periods 1992-1995 and 2000-2002, there was a 31% increase in the incidence of HCC in Hispanic men and a 63% increase in Hispanic women. The race-specific, age-adjusted mortality rates were remarkably similar in California and Texas and were highest in immigrant Asian/Pacific Islanders followed by native Hispanics. The rates for native Hispanic men were more than twice as high as those for immigrant Hispanic men. For Texas, the rates for native Hispanic men were 65% higher than those for immigrant Hispanic men.

Conclusion  Hispanics in the United States have high rates of HCC that are second only to Asians/Pacific Islanders.

Author Affiliations: The Sections of Gastroenterology (Drs El-Serag and Lau) and Health Services Research (Drs El-Serag and Davila), Houston Department of Veterans Affairs Medical Center and Baylor College of Medicine, Houston, Texas; and Department of Internal Medicine, Division of Geriatrics, University of Texas Medical Branch, Galveston (Drs Eschbach and Goodwin).

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