Hepatocellular carcinoma — statistics¶
Last curated: 2026-08-30
Figures are kept with source year, population, and method. Estimates from unlike populations are shown side by side and are not averaged.
Global burden and substrate¶
| Statistic | Estimate | Source year/population | Method/source |
|---|---|---|---|
| All-cancer incident cases | ~20 million | 2022; 185 countries | IARC GLOBOCAN modeled estimates (Bray 2024, PMID 38572751) |
| All-cancer deaths | 9.7 million | 2022; 185 countries | IARC GLOBOCAN modeled estimates (Bray 2024, PMID 38572751) |
| Liver-cancer share of cancer deaths | 7.8% | 2022; global | IARC GLOBOCAN modeled estimates (Bray 2024, PMID 38572751) |
| Global chronic liver disease prevalence | ~1.5 billion people | Contemporary global review | Published data plus CDC/GBD synthesis (Moon 2020, PMID 31401364) |
| Chronic liver disease/cirrhosis incidence | 20.7 per 100,000 | Global | Review of epidemiologic sources (Moon 2020, PMID 31401364) |
| Change in CLD/cirrhosis incidence | +13% since 2000 | Global | Review synthesis (Moon 2020, PMID 31401364) |
Etiologic risk and prevention¶
| Statistic | Estimate | Source year/population | Method/source |
|---|---|---|---|
| NAFLD prevalence | ~25% of world population | Evidence summarized through 2020 | Epidemiologic review (Huang 2021, PMID 33349658) |
| HCC incidence in NASH cirrhosis | 0.5%–2.6% per year | International published cohorts | Review range (Huang 2021, PMID 33349658) |
| HCC incidence in non-cirrhotic NAFLD | ~0.1–1.3 per 1,000 patient-years | International published cohorts | Review range (Huang 2021, PMID 33349658) |
| Non-cirrhotic NAFLD HCC relative risk | adjusted HR 2.69 (95% CI 1.33–5.44) | South Korean national cohort; published 2025 | Claims/ICD cohort refined by fatty liver index (Lee 2025, PMID 40345323) |
| HCC incidence in alcohol-associated cirrhosis | 0.9%–5.6% per year | International cohorts | Review range (Huang 2023, PMID 36258033) |
| Alcohol share of global HCC deaths | ~20% | 2019; global | Modeled burden synthesis (Huang 2023, PMID 36258033) |
| Alcohol share of global cirrhosis deaths | ~25% | 2019; global | Modeled burden synthesis (Huang 2023, PMID 36258033) |
| Alcohol per-capita consumption | 5.5 L (2005); 6.4 L (2016); 7.6 L projected (2030) | Global | Modeled trend/projection (Huang 2023, PMID 36258033) |
| HCC occurrence after HCV SVR | 1.54 per 100 person-years | 23 studies; 29,395 treated patients | Random-effects meta-analysis (Lv 2024, PMID 38965190) |
| HCC occurrence after HCV nonresponse | 7.80 per 100 person-years | Same meta-analysis | Random-effects meta-analysis (Lv 2024, PMID 38965190) |
| HCC occurrence after SVR with cirrhosis | 2.47 per 100 person-years | Treated HCV cohorts | Meta-analysis subgroup (Lv 2024, PMID 38965190) |
| HCC occurrence after SVR without cirrhosis | 0.85 per 100 person-years | Treated HCV cohorts | Meta-analysis subgroup (Lv 2024, PMID 38965190) |
| Taiwan HBV vaccination evaluation | 1,958 HCC cases aged 6–29; 5,524,435 vaccinees in post-program comparison | 1983–2004 Taiwan | Population registries and vaccination records (Chang 2009, PMID 19759364) |
Surveillance performance and outcomes¶
| Statistic | Estimate | Source year/population | Method/source |
|---|---|---|---|
| Shanghai surveillance trial population | 18,816 HBV-infected adults | Shanghai; published 2004 | Randomized surveillance trial (Zhang 2004, PMID 15042359) |
| Trial adherence | 58% | Shanghai HBV trial | Trial follow-up (Zhang 2004, PMID 15042359) |
| HCC mortality effect | Rate ratio 0.63 (95% CI 0.41–0.98) | Shanghai HBV trial | Randomized comparison (Zhang 2004, PMID 15042359) |
| Early detection with surveillance | RR 1.86 | 59 studies; 145,396 cirrhosis patients | Observational meta-analysis (Singal 2022, PMID 35139400) |
| Curative treatment receipt | RR 1.83 | Same meta-analysis | Observational meta-analysis (Singal 2022, PMID 35139400) |
| Survival after lead-time adjustment | HR 0.67 | Same meta-analysis | Observational meta-analysis (Singal 2022, PMID 35139400) |
| Ultrasound sensitivity, any-stage HCC | 84% | Cirrhosis surveillance studies | Meta-analysis (Tzartzeva 2018, PMID 29425931) |
| Ultrasound sensitivity, early-stage HCC | 47% | Cirrhosis surveillance studies | Meta-analysis (Tzartzeva 2018, PMID 29425931) |
| Ultrasound + AFP sensitivity, early-stage | 63% | Cirrhosis surveillance studies | Meta-analysis (Tzartzeva 2018, PMID 29425931) |
| Modeled deaths averted | ~13 per 1,000 over 5 years | Simulated cirrhosis cohort | Decision model (Taylor 2017, PMID 28605060) |
| Modeled false-positive experiences | ~150 per 1,000 over 5 years | Same simulated cohort | Decision model (Taylor 2017, PMID 28605060) |
| Physical-harm model input | 15%–20% | Compensated cirrhosis surveillance | Literature-informed Markov model (Parikh 2020, PMID 32530829) |
| Surveillance-intervention meta-analysis | 9 studies; 4,550 patients | Program studies through 2020 | Systematic review/meta-analysis (Ramai 2023, PMID 34999648) |
| PREMIUM planned enrollment | 4,700 | Recruiting US veterans with cirrhosis; ultrasound+AFP vs abbreviated MRI+AFP | Mortality-powered randomized trial; no outcomes as of 2026-08-30 (NCT05486572; Ioannou 2026, PMID 41624484) |
Diagnostic accuracy¶
| Statistic | Estimate | Source year/population | Method/source |
|---|---|---|---|
| CT/MRI LR-5 sensitivity | 67% (95% CI 62%–72%) | 14 studies; 2,056 patients; 2,589 observations | Random-effects meta-analysis (Lee 2020, PMID 32145134) |
| CT/MRI LR-5 specificity | 92% (95% CI 88%–95%) | Same dataset | Random-effects meta-analysis (Lee 2020, PMID 32145134) |
| CEUS LR-5 sensitivity | 0.71 (95% CI 0.69–0.72) | 8 studies; 4,215 focal lesions | Meta-analysis (Li 2021, PMID 33307595) |
| CEUS LR-5 specificity | 0.88 (95% CI 0.85–0.91) | Same dataset | Meta-analysis (Li 2021, PMID 33307595) |
| CEUS LR-M sensitivity for other malignancy | 0.85 (95% CI 0.81–0.88) | Same dataset | Meta-analysis (Li 2021, PMID 33307595) |
| CEUS LR-M specificity for other malignancy | 0.86 (95% CI 0.85–0.87) | Same dataset | Meta-analysis (Li 2021, PMID 33307595) |
| Needle-biopsy seeding | 0.62%; range 0%–7.77% | 37 studies; 13,959 HCC biopsies | Systematic review (Nie 2025, PMID 39692333) |
| Chinese GALAD validation sample | 602 HCC; 923 controls | Five Chinese centres | Multicentre case-control/longitudinal study (Huang 2022, PMID 34679250) |
| Early BCLC share in GALAD HCC cases | 34.1% BCLC 0–A | Same study | Case characterization (Huang 2022, PMID 34679250) |
Curative and transplant outcomes¶
| Statistic | Estimate | Source year/population | Method/source |
|---|---|---|---|
| Milan four-year overall survival | 85% | Selected cirrhotic HCC transplant cohort | Prospective cohort (Mazzaferro 1996, PMID 8594428) |
| Milan four-year recurrence-free survival | 92% | Same cohort | Prospective cohort (Mazzaferro 1996, PMID 8594428) |
| Metroticket 2.0 discrimination | c-statistic ~0.78 | International transplant cohorts | Competing-risk development/validation (Mazzaferro 2018, PMID 28989060) |
| RETREAT three-year recurrence, score 0 | 1.6% | 3,276 UNOS transplant recipients | External validation (Mehta 2018, PMID 29068145) |
| RETREAT three-year recurrence, score ≥5 | 29% | Same cohort | External validation (Mehta 2018, PMID 29068145) |
| RETREAT three-year survival, score 0 | 91% | Same cohort | External validation (Mehta 2018, PMID 29068145) |
| RETREAT three-year survival, score ≥5 | 58% | Same cohort | External validation (Mehta 2018, PMID 29068145) |
| RFA vs MWA complete ablation | 96.7% vs 96.9% | 5 RCTs; 413 RFA and 431 MWA | RCT meta-analysis (Yu 2021, PMID 33870454) |
| RFA vs resection evidence base | 3 RCTs + 20 retrospective; 15,482 patients | Small HCC studies through 2014 | Meta-analysis (Feng 2015, PMID 24889505) |
Locoregional therapy¶
| Statistic | Estimate | Source year/population | Method/source |
|---|---|---|---|
| TARE vs TACE overall-survival difference | −0.55 months (95% CI −1.95 to 3.05) | 17 studies; 2,465 patients | Aggregate meta-analysis (Brown 2023, PMID 35943116) |
| Mean time to progression | TARE 17.5 vs TACE 9.8 months | 3 studies with TTP | Comparative meta-analysis (Brown 2023, PMID 35943116) |
| Mean TTP difference | 4.8 months (95% CI 1.3–8.3) | Same studies | Comparative meta-analysis (Brown 2023, PMID 35943116) |
Systemic phase 3 anchors¶
| Trial/statistic | Estimate | Population | Method/source |
|---|---|---|---|
| SHARP median OS | 10.7 vs 7.9 months | Advanced HCC; sorafenib vs placebo | Phase 3 RCT (Llovet 2008, PMID 18650514) |
| SHARP OS hazard ratio | 0.69 | Same trial | Phase 3 RCT (Llovet 2008, PMID 18650514) |
| REFLECT median OS | 13.6 vs 12.3 months | Unresectable HCC; lenvatinib vs sorafenib | Phase 3 non-inferiority RCT (Kudo 2018, PMID 29433850) |
| REFLECT OS hazard ratio | 0.92 | Same trial | Phase 3 RCT (Kudo 2018, PMID 29433850) |
| RESORCE median OS | 10.6 vs 7.8 months | Post-sorafenib; regorafenib vs placebo | Phase 3 RCT (Bruix 2017, PMID 27932229) |
| RESORCE OS hazard ratio | 0.63 | Same trial | Phase 3 RCT (Bruix 2017, PMID 27932229) |
| CheckMate 9DW median OS | 23.7 vs 20.6 months | 668 randomized patients; nivolumab-ipilimumab vs lenvatinib/sorafenib | Global phase 3 interim analysis (Yau 2025, PMID 40349714) |
| CheckMate 9DW OS hazard ratio | 0.79 (95% CI 0.65–0.96) | Median follow-up 35.2 months | Global phase 3 interim analysis (Yau 2025, PMID 40349714) |
| CheckMate 9DW early/late OS HRs | First 6 months 1.65 (95% CI 1.12–2.43); thereafter 0.61 (0.48–0.77) | Non-proportional survival effect | Prespecified global phase 3 analysis (Yau 2025, PMID 40349714) |
| IMbrave050 updated RFS | HR 0.90 (95% CI 0.72–1.12) | 668 high-risk patients after resection/ablation; atezolizumab-bevacizumab vs surveillance | Initial benefit not sustained (Yopp 2026, PMID 41580093) |
| IMbrave050 updated OS | HR 1.26 (95% CI 0.85–1.87) | Second interim analysis; OS immature | Benefit–risk did not support adjuvant use (Yopp 2026, PMID 41580093) |
| LEVIATHAN post-atezolizumab-bevacizumab OS | 11.9 vs 7.4 months; HR 0.67; p=0.018 | Lenvatinib vs sorafenib; 230-patient observational comparison | Propensity adjustment does not replace randomization (Lombardi 2025, PMID 41321927) |
Disparities and access¶
| Statistic | Estimate | Population/method | Source |
|---|---|---|---|
| Black vs White survival | pooled HR 1.08 (95% CI 1.05–1.12) | 35 US studies; 563,097 HCC patients | Meta-analysis (Rich 2022, PMID 33387668) |
| Black vs White early-stage detection | OR 0.66 (95% CI 0.54–0.78) | 20 studies reporting stage | Meta-analysis (Rich 2022, PMID 33387668) |
| Curative treatment receipt | 18.9% (2,617/13,874) | SEER-Medicare, age ≥65, 2001–2015 | Retrospective cohort (Wagle 2022, PMID 34796703) |
| Black vs White curative treatment | OR 0.76 (95% CI 0.64–0.91) | Same cohort | Adjusted logistic model (Wagle 2022, PMID 34796703) |
| Low-SES Black vs White curative treatment | OR 0.64 (95% CI 0.49–0.84) | High-poverty neighborhoods | Stratified adjusted model (Wagle 2022, PMID 34796703) |
| SEER disparity cohort | 45,789 HCC cases | Histologically confirmed, 2000–2015 | Population registry (Flores 2021, PMID 33737301) |
| Incidence extremes in SEER analysis | 12.1 low-SES API vs 3.2 high-SES White | Rates per 100,000 | Age-adjusted SEER analysis (Flores 2021, PMID 33737301) |
Patient experience¶
| Statistic | Estimate | Population/method | Source |
|---|---|---|---|
| Qualitative review | 11 studies; 5 thematic domains | Systematic qualitative synthesis | Norman 2022, PMID 35974658 |
| International journey study | 50 patients + 12 clinicians | Semi-structured interviews | Wörns 2024, PMID 39052152 |
| HCC interview study | 25 patients; median age 63; 68% men | Qualitative concept elicitation | Patel 2022, PMID 34115280 |
| Terminal HCC longitudinal study | 14 patients; 45 interviews | Monthly interviews up to 6 months | Hansen 2015, PMID 25122134 |
| Caregiver longitudinal study | 13 caregivers; 39 interviews | Monthly interviews up to 6 months | Hansen 2017, PMID 28820518 |
2026-08-30 epidemiology and prevention additions¶
| Statistic | Estimate | Population/method | Source |
|---|---|---|---|
| Global HBV-attributable fraction of HCC | 52%; ~345,434 cases | 857 publications; 81 countries/territories; applied to 2022 burden | Meta-analysis (Cao 2026, PMID 42135055) |
| Global HCV-attributable fraction of HCC | 21%; ~134,418 cases | Same analysis | Meta-analysis (Cao 2026, PMID 42135055) |
| HBV-attributable fraction, Eastern Asia | 70% | Regional pooled prevalence among HCC | Meta-analysis (Cao 2026, PMID 42135055) |
| HCV-attributable fraction, Northern Africa | 77% | Regional pooled prevalence among HCC | Meta-analysis (Cao 2026, PMID 42135055) |
| Anti-HDV prevalence among HBsAg-positive people | 4.5% (95% CI 3.6%–5.7%) | 282 studies; 120,293 HBsAg-positive people | Meta-analysis (Stockdale 2020, PMID 32335166) |
| HDV population-attributable fraction for HCC among HBsAg-positive people | 20% (95% CI 8%–33%) | Preliminary random-effects estimate | Meta-analysis (Stockdale 2020, PMID 32335166) |
| Aflatoxin-attributable HCC fraction | 17% (14%–19%) overall; 21% HBV-positive; 8.8% HBV-negative | 17 studies; 1,680 cases and 3,052 controls | Meta-analysis (Liu 2012, PMID 22405700) |
| Aflatoxin plus HBV interaction | OR 73.0 (95% CI 36.0–148.3) | Sensitivity analysis excluding one heterogeneous study | Meta-analysis (Liu 2012, PMID 22405700) |
| Coffee, per additional two cups/day | RR 0.65 (95% CI 0.59–0.72) | 18 cohorts plus 8 case-control studies | Dose-response meta-analysis; very-low GRADE certainty (Kennedy 2017, PMID 28490552) |
| Diabetes in chronic HBV | HR 1.26 (95% CI 1.20–1.32), fixed effect; 1.36 (1.23–1.49), random effects | 40 observational studies; DM subset meta-analysis | Campbell 2021, PMID 33305479 |
| Smoking in MASLD | RR 1.30 (95% CI 1.08–1.57) | 31 studies; 1.02 million people across modifiable-factor analysis | Meta-analysis (Xiao 2024, PMID 39047929) |
2026-08-30 surveillance, diagnosis, and biomarkers¶
| Statistic | Estimate | Population/method | Source |
|---|---|---|---|
| Six- versus twelve-month surveillance, early-stage detection | RR 1.17 (95% CI 1.08–1.26) | 13-study interval/modality meta-analysis | Yang 2023, PMID 36921104 |
| Six- versus twelve-month surveillance, five-year survival | RR 1.39 (95% CI 1.07–1.82) | Same meta-analysis | Yang 2023, PMID 36921104 |
| Annual HBV screening, corrected mortality | HR 0.74 (95% CI 0.60–0.91) prevalent round; 0.52 (0.40–0.68) incident rounds | 14,426 HBsAg-positive adults; prospective community cohort | Zeng 2023, PMID 37667043 |
| Severe visualization limitation in NAFLD cirrhosis | Ultrasound 35% vs abbreviated MRI 19% | 54-person prospective paired study | Huang 2022, PMID 35229334 |
| Obesity and severe ultrasound limitation | OR 5.1 (95% CI 1.1–23.1) | Same study | Huang 2022, PMID 35229334 |
| LR-5 sensitivity, MRI versus CT | 61% (95% CI 43%–76%) vs 48% (31%–65%) | 7 comparative studies; 1,145 observations | Meta-analysis (Kim 2022, PMID 35849177) |
| LR-5 specificity, MRI versus CT | 93% (95% CI 88%–96%) vs 96% (92%–98%) | Same analysis | Meta-analysis (Kim 2022, PMID 35849177) |
| CEUS LR-5 sensitivity/specificity | 69% (95% CI 64%–73%) / 92% (83%–96%) | 11 studies; 5,535 observations | Meta-analysis (Shin 2020, PMID 32722894) |
| Longitudinal GALAD sensitivity at 90% specificity | 66.7%; AFP 40.5% | 397 cirrhosis patients; 42 incident HCC | Prospective-specimen blinded evaluation (Singal 2022, PMID 34618932) |
| HES V2.0 incremental TPR over GALAD | +7.2% overall at 10% false-positive rate | 2,331 patients; 125 HCC | Phase-3 biomarker study (El-Serag 2025, PMID 38899967) |
| External HES V2.0/GALAD AUROC | 0.79 for both | HEDS cohort; 1,485 patients, 119 HCC | PRoBE validation (El-Serag 2026, PMID 41043723) |
| cfDNA diagnostic meta-analysis | Sensitivity 0.54; specificity 0.90; AUC 0.82 | 38 studies; HCC versus healthy-control dominated | Zhang 2021, PMID 33470842 |
2026-08-30 treatment, transplant, and safety additions¶
| Statistic | Estimate | Population/method | Source |
|---|---|---|---|
| Downstaging success | 55.16% (95% CI 45.49%–64.46%) | 25 studies; 3,997 patients | Meta-analysis (Tan 2023, PMID 35181565) |
| Transplant after downstaging, intention to treat | 31.52% (95% CI 24.03%–40.11%) | Same analysis | Tan 2023, PMID 35181565 |
| Recurrence after transplant among downstaged recipients | 16.01% (95% CI 11.80%–21.37%) | Same analysis | Tan 2023, PMID 35181565 |
| Adjuvant TACE, broad stage I/II | RFS HR 0.88 (95% CI 0.62–1.24), p=0.468 | Phase 3 RCT; 332 patients | Ma 2025, PMID 39808820 |
| Adjuvant TACE, selected HBV/high-risk | RFS HR 0.68 | Phase 3 RCT; 280 patients | Wang 2018, PMID 29420221 |
| SBRT versus RFA for recurrent small HCC | Local-PFS HR 0.45 (95% CI 0.24–0.87); two-year local PFS 92.7% vs 75.8% | Randomized trial; 166 patients | Xi 2025, PMID 39693584 |
| HIMALAYA five-year OS | 19.6% STRIDE vs 9.4% sorafenib; HR 0.76 (95% CI 0.65–0.89) | Phase 3 five-year update | Rimassa 2025, PMID 40222621 |
| KEYNOTE-240 OS | 13.9 vs 10.6 months; HR 0.781 (95% CI 0.611–0.998); p=0.0238 | Phase 3; prespecified alpha 0.0174 | Finn 2020, PMID 31790344 |
| Variceal bleeding on atezolizumab-bevacizumab | 7.0%; six-month 6.3%; twelve-month 7.4% | 640 pre-treatment-endoscoped patients | Retrospective cohort (Park 2025, PMID 39871662) |
| Acute renal failure after TACE | 8.6% (12/140) | Prospective cohort | Huo 2004, PMID 15189271 |
| ICI-exposed transplant rejection | 26.4% (24/91) | Individual-patient meta-analysis | Rezaee-Zavareh 2025, PMID 38996924 |
| Rejection with pre-LT ICI washout <30 days | OR 21.3 (95% CI 5.93–103) versus >50 days | International retrospective cohort; 119 recipients | Moeckli 2025, PMID 40042053 |
2026-08-30 disparities and patient priorities¶
| Statistic | Estimate | Population/method | Source |
|---|---|---|---|
| Treatment delay >3 months | 14.3% (1,205/8,450) | SEER-Medicare treated within 12 months | Wagle 2023, PMID 35933076 |
| Black race and treatment delay | OR 1.96 (95% CI 1.21–3.15) | Adjusted model | Wagle 2023, PMID 35933076 |
| High-poverty neighborhood and treatment delay | OR 1.55 (95% CI 1.25–1.92) | Adjusted model | Wagle 2023, PMID 35933076 |
| Treatment delay and mortality | HR 1.15 (95% CI 1.05–1.25) | Five-month landmark analysis | Wagle 2023, PMID 35933076 |
| Early BCLC 0/A presentation | 42.0% | Four-system US cohort; 2,263 patients | Rich 2024, PMID 39666898 |
| Black versus White early presentation | OR 0.63 (95% CI 0.45–0.89) | Fully adjusted model | Rich 2024, PMID 39666898 |
| Preference importance: surveillance sensitivity | 51.3% (95% CI 49.0%–53.4%) | Discrete-choice study; 179 completed surveys | Woolen 2022, PMID 33618022 |
| Simulated abbreviated-MRI preference | 29.0%; ultrasound alone 3.4% | Same study | Woolen 2022, PMID 33618022 |
| Daily function versus survival tradeoff | Ten months maintained function valued at least as much as ten months OS | 200 US patients with unresectable HCC | Discrete-choice study (Li 2023, PMID 36900262) |
Known conflicts and caveats¶
- Global burden sources often count all liver cancer, not HCC histology alone.
- Annual incidence ranges mix etiologies, fibrosis definitions, and surveillance intensity.
- Post-HCV-cure estimates depend strongly on cirrhosis ascertainment and prior HCC.
- Surveillance survival estimates are observational and remain vulnerable to lead-time, length-time, and healthy-user bias.
- Diagnostic meta-analyses often use lesion-level rather than patient-level denominators.
- Transplant outcomes are highly selected and should not be applied to all HCC.
- Systemic RCTs predominantly enrolled Child-Pugh A, performance-preserved patients.
- Cross-trial median survival comparisons are not treatment rankings.
- Race/ethnicity disparity estimates reflect social and structural pathways, not biological racial effects.