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Trends in Liver Cancer Death Rates by Educational Attainment

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Key Points

  • From 2000–2015, the overall liver cancer death rate (per 100,000 persons) increased from 7.5 to 11.2 in men and from 2.8 to 3.8 in women—with the increase largely confined to individuals with less educational attainment.
  • The increase was generally steeper in less educated groups for women and was confined to persons with ≤ 15 years of education for men. 
  • The educational disparities in liver cancer mortality widened in women until 2006, then leveled off, while they continued to widen in men.

A new study has found that rising rates of liver cancer deaths in the United States have largely been confined to individuals who have received less education—especially among men. Published by Ma et al in Cancer, the findings emphasize the need for enhanced efforts to address the growing burden of liver cancer in lower socioeconomic groups.

Liver cancer—which, in some cases, is caused by infection with the hepatitis C virus (HCV)—is the most rapidly rising cause of cancer death in the United States. Previous studies have examined varying trends in liver cancer mortality, but there have been no studies examining recent national trends by individual-level socioeconomic status and/or HCV-infection status.

Methods

To investigate, Jiemin Ma, PhD, MHS, of the American Cancer Society, and colleagues analyzed mortality data published by the National Vital Statistics System of the National Center for Health Statistics from 2000–2015. The team looked specifically at trends in death rates from liver cancer by individual-level educational attainment, HCV infection status, race/ethnicity, and sex among persons aged 25–74 years.

Findings

From 2000–2015, the overall liver cancer death rate (per 100,000 persons) increased from 7.5 to 11.2 in men and from 2.8 to 3.8 in women—with the increase largely confined to individuals with less educational attainment. The increase was generally steeper in less educated groups for women and was confined to persons with ≤ 15 years of education for men. 

The educational disparities in liver cancer mortality widened in women until 2006, then leveled off, while they continued to widen in men.

Although death rates increased faster for HCV-related than HCV-unrelated liver cancers, the overall liver cancer mortality trends were largely driven by HCV-unrelated liver cancers. “Classifying liver cancer deaths into HCV-related and HCV-unrelated groups allowed us to more thoroughly understand the recent pattern of liver cancer mortality,” said Dr. Ma.

Risk factors for HCV-unrelated liver cancers include obesity, diabetes, smoking, and excessive alcohol consumption.

“To our knowledge, this study is among the first to examine the recent trends in liver cancer death rates by individual-level education and by HCV-infection status,” said Dr. Ma. “Our findings underscore the need for enhanced and targeted efforts in lower socioeconomic groups to halt and reverse the undue growing burden of liver cancer.”

Disclosure: The study authors’ full disclosures can be found at onlinelibrary.wiley.com.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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