Projected Incidence of Hepatobiliary Cancers and Trends Based on Age, Race, and Gender in the United States

Simple Summary Using historical data from the Surveillance, Epidemiology, and End Results database from 2001 to 2017, we were able to project the incidence of hepatobiliary malignancies between 2018 and 2029, and we expect rates of hepatobiliary malignancies to continue to increase during this time period. Specifically, rates of hepatocellular carcinoma and intrahepatic cholangiocarcinoma are expected to double from 2001 to 2029. The incidences of gallbladder carcinoma and ampullary cancer are expected to remain stable, while the incidence of extrahepatic cholangiocarcinoma is expected to increase. Certain age, racial, and gender subgroups are specifically expected to have higher rates of certain hepatobiliary malignancies in the coming years, including hepatocellular cancer and intrahepatic cholangiocarcinoma among whites, gallbladder cancer among blacks, and extrahepatic cholangiocarcinoma among Hispanics. Using this information, we can begin to allocate resources for screening, management, and research going forward, with a focus on specific cancer types and demographic groups. Abstract Background: Identifying the projected incidence of hepatobiliary cancers and recognizing patient cohorts at increased risk can help develop targeted interventions and resource allocation. The expected incidence of subtypes of hepatobiliary cancers in different age groups, races, and genders remains unknown. Methods: Historical epidemiological data from the Surveillance, Epidemiology, and End Results (SEER) database was used to project future incidence of hepatobiliary malignancies in the United States and identify trends by age, race, and gender. Patients ≥18 years of age diagnosed with a hepatobiliary malignancy between 2001 and 2017 were included. US Census Bureau 2017 National Population projects provided the projected population from 2017 to 2029. Age–Period–Cohort forecasting model was used to estimate future births cohort-specific incidence. All analyses were completed using R Statistical Software. Results: We included 110381 historical patients diagnosed with a hepatobiliary malignancy between 2001 and 2017 with the following subtypes: hepatocellular cancer (HCC) (68%), intrahepatic cholangiocarcinoma (iCCA) (11.5%), gallbladder cancer (GC) (8%), extrahepatic cholangiocarcinoma (eCCA) (7.6%), and ampullary cancer (AC) (4%). Our models predict the incidence of HCC to double (2001 to 2029) from 4.5 to 9.03 per 100,000, with the most significant increase anticipated in patients 70–79 years of age. In contrast, incidence is expected to continue to decline among the Asian population. Incidence of iCCA is projected to increase, especially in the white population, with rates in 2029 double those in 2001 (2.13 vs. 0.88 per 100,000, respectively; p < 0.001). The incidence of GC among the black population is expected to increase. The incidence of eCCA is expected to significantly increase, especially among the Hispanic population, while that of AC will remain stable. Discussion: The overall incidence of hepatobiliary malignancies is expected to increase in the coming years, with certain groups at increased risk. These findings may help with resource allocation when considering screening, treatment, and research in the coming years.