Spotlight on cancer trends
Mortality from gastric cancer in the U.S. was lower in 2022 than 1999, one study showed, while another provided the first evidence of a drop in incidence of hepatocellular carcinoma among those older than age 65 years beginning in 2019.
Two new studies reported some good news about gastric and hepatic cancer incidence and mortality in the U.S.
The first study, published by the Journal of Clinical Gastroenterology on Oct. 14, analyzed gastric cancer-related mortality trends in the U.S. over two decades. It used deidentified death certificates from 1999 to 2022 and found that age-adjusted mortality rates from gastric cancer decreased from 79.26 per million in 1999 to 44.81 per million in 2022. Patients who were male, older, or Black had higher age-adjusted mortality from gastric cancer, as did northeastern states and urban areas compared to other parts of the country.
“This decline in [age-adjusted mortality rates] aligns temporally with advances in dietary guidelines, improved sanitation, perioperative chemotherapy, eradication of H. pylori, and the introduction of endoscopic resection techniques for earlier detection of [gastric cancer], though our study cannot establish causality,” said the study authors. “Despite declining mortality, persistent disparities highlight the need for targeted screening in high-risk groups (older adults, males, and [non-Hispanic] Black/Asian populations) and improved resource allocation in high-burden regions.”
The second study, published by Clinical Gastroenterology and Hepatology on Oct. 18, assessed mortality rates and treatment of hepatocellular carcinoma (HCC) in the U.S. It found that incidence increased from 2000 to 2014 (annual percentage change [APC], 5.54% from 2000 to 2007 and 3.12% from 2007 to 2014), then plateaued in 2014 to 2019 (APC, −0.52%) and declined from 2019 to 2022 (APC, −3.74%). Mortality from HCC increased from 2000 to 2013 (APC, 26.6% in 2000 to 2002 and 4.29% in 2002 to 2013) and plateaued during 2013 to 2022 (APC, 0.13%). During the COVID-19 pandemic (2020 to 2022), there were lower odds of curative treatment for HCC and higher odds of no treatment.
Incidence trends differed by age group, with a continual downward trend seen since 2005 among those younger than age 50 years. Among those ages 65 years and older, HCC incidence increased until 2019, then decreased between 2019 and 2022, a finding that was notable, according to the study authors. “HCC incidence rates had increased steadily in individuals aged ≥65 years since 2000 but began to trend downward in 2019. This decline could potentially be attributed to the reduction of hepatitis C virus (HCV)-related cirrhosis and HCC occurrence due to direct-acting antivirals (DAAs),” they said. The authors called for future research to look at the long-term impact of decreased treatment during the pandemic.