Geographic and temporal trends in etiology, incidence, and mortality from hepatocellular carcinoma in European Union 15+ countries

Background & Aims: Hepatocellular carcinoma (HCC) is the third leading cause of cancer mortality worldwide. This study considers the geographical trends in incidence and mortality from HCC. Methods: Data were obtained for each EU15+ country from the Global Burden of Disease Study database. Age-standardized incidence rates (ASIRs), mortality rates (ASMRs) and disability-adjusted life years (DALYs) were extracted for each year from 1990-2019. Data were subdivided into males and females. Mortality-to-incidence ratios (MIRs) were calculated. All Indices were reported per 100,000 population, and trends were described using Joinpoint regression. Results: ASIRs increased in 17/19 countries in females and 18/19 countries in males between 1990 and 2019. ASMRs increased in all countries except Italy (for both sexes) and Sweden (for females). MIR decreased in all countries except Denmark in males (+8.0) and females (+1.2). Ireland saw the greatest decline in MIR among females (-15.0%) and the United Kingdom for males (-16.4%). DALYs increased in all countries except Italy for males and females and Sweden for females. Conclusions: The incidence of and mortality from hepatocellular carcinoma are increasing in the majority of EU15+ countries. The rise in mortality and fall in MIR may suggest that outcomes from HCC are improving, despite an increased disease burden