Annual increase in HCC deaths higher among rural vs urban residents

Rural area residents have seen greater increases in hepatocellular carcinoma (HCC) deaths each year than those living in urban areas, reveals a study.

“Deaths from hepatitis C virus (HCV)-related HCC have declined with a geographical disparity that favours urban populations, possibly driven by decreased access to HCV screening or availability of highly effective direct-acting antiviral therapies for rural residents,” the investigators said.

The National Vital Statistics System was used in this study to analyse the crude and age-adjusted HCC death rates overall and by aetiology for rural and urban residents from 2005 to 2023. The investigators identified changes in annual percentage change (APC) in HCC mortality rates using the National Cancer Institute Joinpoint Trend Analysis Software.

The average APC in HCC deaths over time was significantly higher among rural residents (crude average APC, 4.64, 95 percent confidence interval [CI], 4.10‒5.34; age-adjusted average APC, 3.53, 95 percent CI, 3.09‒4.07) than those living in urban areas (crude average APC, 2.72, 95 percent CI, 2.43‒3.01; age-adjusted average APC, 1.68, 95 percent CI, 1.28‒2.13).

Notably, a significantly greater recent decline in HCC cases from HCV in urban residents (crude APC, ‒6.69, 95 percent CI, ‒8.85 to ‒5.30 from 2017 to 2023) compared with rural residents (crude APC, ‒3.31, 95 percent CI, ‒8.05 to 0.73 from 2016 to 2023) propelled the differences in HCC death rate changes.

“These findings underscore the need for targeted HCV screening and treatment strategies in rural populations in addition to ongoing strategies to combat alcohol use and metabolic diseases,” the investigators said.