Birth Cohort Patterns in Liver Cancer Incidence in the United States: An Age-Period-Cohort Analysis Open Access

Bashirian, Dongdong (Summer 2024)

Permanent URL: https://etd.library.emory.edu/concern/etds/0g354g93j?locale=en
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Abstract

Background: Liver cancer incidence has been increasing in the United States (US). Data on birth cohort patterns of liver cancer incidence rates among different demographic groups based on up-to-date and nationwide data are lacking in the US.

Methods: Data on primary liver cancer incidence, including intrahepatic bile duct cancer (ICD-O-3 C22.0 and C22.1), in the US from 2000 to 2020 were obtained from population-based cancer registries. Age-specific incidence rates and age-standardized incidence rates (ASR) were computed by sex and race and ethnicity. Temporal trends in ASR were assessed using Joinpoint regression model. Birth cohort and period effects were examined using age-period-cohort (APC) analysis.

Results: In 2016-2020, incidence rates were nearly three times as high in males as in females. The highest rates were observed in non-Hispanic American Indian/Alaska Native (AIAN) males and females. Incidence rates continuously increased from 2000 to 2019 among non-Hispanic AIAN males and Hispanic Black females. Conversely, rates in non-Hispanic Black males sharply decreased since 2015, and rates in both non-Hispanic Asian Pacific Islander (API) males and females decreased since 2007-2008. By birth cohort, the risk of liver cancer among men peaked in those born circa 1955, declined in successive younger birth cohorts until circa 1970 birth cohort, and then stabilized afterwards for all racial and ethnic groups except for non-Hispanic API in whom the risk decreased and for non-Hispanic White in whom the risk increased in the successive younger cohorts after circa 1970 birth cohort. In contrast, the risk among women continued to increase in successive younger birth cohorts in each racial and ethnic population except it declined in non-Hispanic API after peaking in 1930 cohort. Likewise, age-specific incidence rates in individuals aged younger than 40 years continued to increase in successively younger birth cohorts among women of each racial and ethnic groups (except for API populations) and among non-Hispanic White men.

Conclusions: The risk of liver cancer is rapidly increasing in successive birth cohorts among non-Hispanic White men and in most populations of women born after 1970s. Further studies are needed to elucidate the underlying risk factors for the rising incidence to plan preventive measures. 

Table of Contents

Chapter 1 Background Literature Review

Student Contribution

Chapter 2 Journal Article

Title

Abstract

Introduction

Methods

Results

Discussion

Figures and Tables

Chapter 3 Future Directions/Public Health Implications

Reference

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