Washington, D.C., has the nation’s highest liver cancer death rate, according to the Centers for Disease Control and Prevention in data published Tuesday that show a more than 40 percent increase in the national rate since 2000.
Nationally, deaths attributable to liver cancer increased from 7.2 per 100,000 people in 2000 to 10.3 per 100,000 people in 2016 — a 43 percent increase, the CDC data show. For the nation’s capital, the death rate was 16.8 per 100,000. Vermont, with the lowest rate, had six liver cancer deaths per 100,000.
“Liver cancer doesn’t really get the exposure that it requires in terms of coverage and general public awareness,” said Dr. Kirti Shetty, director of hepatology at Sibley Memorial Hospital and associate professor of medicine at Johns Hopkins University. “It highlights the importance of all of the various causes of liver cancer, which are very prevalent in a population like the one in D.C.”
Dr. Shetty noted that the District also leads the nation in infection rates for hepatitis C and HIV, two prominent risk factors for liver cancer. She said it’s important to undergo screening for hepatitis C, especially in the baby boomer population, because it is a treatable condition.
“Early detection really makes a difference in treatment outcomes,” she said.
Liver cancer has become the sixth leading cause of cancer death in the U.S., up from ninth place 17 years ago.
Jiaquan Xu, an epidemiologist at the National Center for Health Statistics, said there were surprising results in the latest data, such as while death rates for many diseases are declining, liver cancer deaths are increasing.
“This data brief focuses on the year 2000 to 2016, and when we look at the major leading causes of death, many of them decreased for heart disease, all cancer combined, stroke, those kind of things,” he said. “When we look at the detail for liver cancer, this goes the opposite way. Liver cancer actually increased.”
According to the CDC, liver cancer death rates for men increased 10.5 per 100,000 people in 2000 to 15 per 100,000 in 2016 — a 43 percent increase. Women saw a 40 percent increase — from 4.5 per 100,000 to 6.3 per 100,000 — over the same period.
Hispanic adults had the highest number of U.S. liver cancer deaths, but their death rate increased by the lowest amount — 27 percent between 2000 and 2016.
Meanwhile, the liver cancer death rate increased by 48 percent among white adults and 43 percent among black adults.
Asian/Pacific Islanders were the only demographic group with a decline in the death rate — 22 percent — from 17.5 per 100,000 in 2000 to 13.6 per 100,000 in 2016.
Data were taken from mortality files for U.S adults age 25 and older from the National Vital Statistics System from 2000 to 2016.
“We hope the public or the public health can use this data for their work and also we hope we can raise awareness of this issue, especially liver cancer death in this country,” Mr. Xu said.
According to the National Cancer Institute estimates, this year has seen 42,220 new liver cancer cases and 30,200 related deaths — about 5 percent of all cancer deaths. The five leading cancer-death categories are lung cancer, colorectal cancer, breast cancer, prostate cancer and leukemia (24,370), the NCI says.
Leading causes of liver cancer are tied to hepatitis B and C, both of which are increasing in the population and in conjunction with the opioid epidemic, as more people inject drugs.
Hepatitis B infections were largely coming under control in the U.S. since the 1990s with implementation of a vaccine, with around 3,000 new cases per year.
But in 2016, the CDC estimated that the actual number of cases was 6 times greater, with 20,900 acute hepatitis B cases.
New cases of hepatitis C also dramatically increased, most glaringly between 2010 and 2016, the CDC says. Between 2015 and 2016, new cases increased by 21.8 percent.
More than 4 million people are living with hepatitis B or C in the U.S., with most of them unaware of the disease.
Other risk factors include heavy alcohol use, cirrhosis of the liver, obesity and diabetes.