Increasing contribution of non-alcoholic fatty liver disease to hepatocellular carcinoma incidence and mortality in U.S. Medicare

Hepatocellular carcinoma (HCC) has one of the fastest growing rates of cancer-related incidence and mortality in the United States (U.S.) (1-3). From 2009 to 2013, the average annual percent change (AAPC) for liver cancer incidence became the highest among other reported cancers for both males (+2.9%) and females (+3.8%) (1). In addition, cancer-related mortality rates for liver cancer are the highest among solid malignancies from 2010 to 2014 for males (+2.6%) and females (+3.0%) (1). Morbidity and mortality from HCC are expected to increase, predominantly driven by an increasing prevalence of HCV-associated cirrhosis and non-alcoholic fatty liver disease (NAFLD) (2).