Heatmap

In 2020, the National Cancer Institute (NCI) estimated that there will be 42,810 new cases of liver and intrahepatic bile duct cancers and 30,160 deaths in the United States.¹ About 75 percent of these cases are HCC.² ACCC developed a liver cancer heatmap to better understand prevalence, mortality, disparities in access to care for those with hepatocellular carcinoma (HCC). 

Data on liver cancer rates from 2012-2016 from the United States Cancer Statistics³ (which includes data from the Surveillance, Epidemiology, and End Results Program (SEER) and National Program of Cancer Registries) were used to develop this map, which can be searched by age-adjusted incidence rate, crude incidence rate, number of cases, mortality, and mortality-to-incidence ratio. In addition, National Cancer Institute (NCI) designated cancer centers and ACCC Cancer Program Members are overlaid to show where these treatment facilities exist within each state.  

Data from the heatmap can be useful in a number of ways. States with high incidence might consider interventions to decrease risk of HCC, such as broad public awareness campaigns and developing education materials for use with higher risk patients in primary care and gastroenterology practices. States with high mortality rates may look at interventions resulting in earlier diagnosis or better access to treatment. The number of cases can help users understand resource allocation needs, and the mortality to incidence ratio (MIR) can indicate disparities in access to care. However, it’s important to remember that barriers to accessible care can be related to several factors, including race, socioeconomic status, and geography. More research is needed to understand disparities and their causes but ensuring that community cancer centers can provide access to HCC specialists may help bridge the gap between incidence and mortality rates.

Limitations: State-level data can help show the big picture of HCC when it comes to broader planning purposes, such as to determine cancer plan priorities at the state level or general resource needs, but it should only be considered as a starting point. Due to geographic variation among these statistics, it is less useful for local planning purposes. Learning more about patient populations through barrier assessment will be helpful in identifying disparities, but it may not fully capture the impact of certain demographics or cultural norms when it comes to risk reduction, care seeking, and treatment acceptance.

References

1. National Cancer Institute: Surveillance, Epidemiology, and End Results (SEER) Program. Cancer stat facts: liver and intrahepatic bile duct cancer. Available online at: https://seer.cancer.gov/statfacts/html/livibd.html. Last accessed July 16, 2020.
2. American Cancer Society. Cancer facts and figures: 2020. Available online at: https://www.cancer.org/research/cancer-facts-statistics/all-cancer-facts-figures/cancer-facts-figures-2020.html. Last accessed: October 6, 2020.
3. United States Departmen of Health and Human Services, Centers for Disease Control and Prevention and National Cancer Institute. United States Cancer Statistics - Incidence: 1999 - 2016, WONDER online database. Available online at: http://wonder.cdc.gov/cancer-v2016.html. Last accessed: December 8, 2019.