ArticleCancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology2025
The Changing Pathogenesis of Liver Cancer in Hawaii over Three Decades.
Article in Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundWorldwide trends support the increasing contribution of hepatic steatosis to the incidence of hepatocellular carcinoma (HCC). This study investigates if similar changes are seen in Hawaii, where the incidence of HCC is higher than in most of the United States.
methodsThis is a retrospective study of 1,651 patients diagnosed with HCC (1991-2023) that includes 60% to 70% of HCC cases in Hawaii. We evaluated changes in patient demographics, risk factors, and disease etiology over the past three decades.
resultsFrom 1991 to 2023, there were significant increases in the proportion of HCC cases attributable to metabolic dysfunction-associated steatotic liver disease (MASLD), coinciding with an increase in the prevalence of metabolic risk factors including obesity, diabetes, hyperlipidemia, and hypertension. Cases with a history of smoking also increased through 2020. Conversely, HCC cases presenting with cirrhosis alone decreased. Hepatitis C virus (HCV)-associated cases increased through 2015 and then tapered, whereas Hepatitis B virus (HBV)-associated cases decreased through 2020. There was no significant change in the proportion of alcohol-associated cases.
conclusionsAlthough HBV continues to be a major contributor to HCC in Hawaii, HCV-related HCC cases have tapered, whereas metabolic risk factors for HCC and cases attributable to MASLD have increased over time, paralleling overall trends observed in the United States. Efforts are needed to manage these metabolic factors to address the burden of HCC. IMPACT: Although Hawaii continues to have a large burden of viral hepatitis-related HCC, metabolic factors and MASLD have affected the pathogenesis of liver cancer in Hawaii over the past three decades.
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