Rural-Urban Disparities in Hepatocellular Carcinoma Incidence and Mortality
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By
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Haluk Damgacioglu
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Gokhan Uygun
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Ashish A. Deshmukh
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Ahmed O. Kaseb
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Anne M. Noonan
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Tarik Demir
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May 13, 2026
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Clinical Scorecard: Disparities in Hepatocellular Carcinoma Incidence and Mortality Between Rural and Urban Populations
At a Glance
| Category | Detail |
|---|
| Condition | Hepatocellular carcinoma (HCC) |
| Key Mechanisms | Chronic viral hepatitis, alcohol-related liver disease, aflatoxin exposure, obesity, metabolic dysfunction-associated steatohepatitis. |
| Target Population | Individuals diagnosed with HCC, particularly in rural and urban settings. |
| Care Setting | Oncology and public health settings. |
Key Highlights
- HCC accounts for approximately 90% of liver cancers.
- Incidence of HCC has increased in rural populations while decreasing in urban areas.
- Emerging risk factors include obesity, diabetes, and alcohol-related liver disease.
- Data sourced from NPCR and SEER databases for analysis of trends from 2001 to 2022.
- Disparities exist in HCC incidence and mortality across different racial and ethnic groups.
Guideline-Based Recommendations
Diagnosis
- Utilize site code C22.0 and histology codes 8170-8175 for HCC identification.
Management
- Focus on improving treatment and prevention of chronic viral hepatitis.
Monitoring & Follow-up
- Regularly assess incidence trends stratified by sex, race, and ethnicity.
Risks
- Monitor for emerging risk factors such as obesity and metabolic dysfunction.
Patient & Prescribing Data
264,633 individuals diagnosed with HCC from 2001 to 2022.
Treatment strategies should consider geographic disparities and emerging risk factors.
Clinical Best Practices
- Implement targeted screening for high-risk populations in rural areas.
- Enhance access to care and treatment for chronic hepatitis in underserved regions.
- Utilize data-driven approaches to address disparities in HCC incidence and outcomes.
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