Abstract
Purpose: Hepatocellular carcinoma incidence rates vary greatly among different ethnic groups. Most of the information regarding the epidemiology of liver cancer in Hispanics is based on evaluation of databases in which there is negligible representation of island Puerto Ricans. The aim of this study was to assess the trends in the incidence and mortality rates of liver cancer in Puerto Ricans, United States (US) Hispanics and the US general population. Methods: We analyzed the databases of the Puerto Rico (PR) Cancer Registry, the US SEER 11, and the PR and US Vital Statistics for all cases of liver cancer diagnosed in the period 1992–2001. A trend analysis of the age-standardized liver cancer incidence/mortality rates (per 100,000) was performed using the direct method (Standard World Population 1960) from 1992–2001. Annual percent change (APC) was estimated with the Poisson model using as predictor year of diagnosis. Results: During the study period, Puerto Ricans and US Hispanics (US-H) showed the highest incidence and mortality trends for liver cancer. The incidence of liver cancer remained stable for Puerto Ricans (APC = 0.06%) yet rapidly increased in the US general population (APC = 4.0%) and US-H (APC = 3.73%). The incidence of liver cancer is increasing in all groups and sexes, except among Puerto Rican females who showed a decreasing incidence trend (APC = -1.99%). Puerto Ricans had the highest mortality rates from liver cancer for both sexes and across all age groups, despite exhibiting a decreasing trend during the study period (APC = -1.68). An increasing mortality trend was evident for both US (APC = 1.08) and US-H (APC = 1.14). Conclusion: Both US Hispanics and Puerto Ricans are disproportionately affected by liver cancer having a higher incidence and mortality rates, respectively, in comparison to the US general population. Further studies should explore the reasons for these ethnic disparities.
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