Incidence of Early-Onset Liver Cancer in Younger Patients Decreasing

Although the incidence of cancer is generally rising among younger patients, the incidence of early-onset hepatocellular carcinoma (HCC; a kind of liver cancer) is declining, according to research simultaneously shared in an article from the Carle Illinois College of Medicine and published in Annals of Surgical Oncology.

HCC is a fast-growing cancer that makes up approximately 90% of all primary liver cancers. The five-year survival rate is approximately 18% and early detection can be difficult. This is because HCC often does not cause symptoms in its initial stages. Therefore, investigators from Carle Illinois College of Medicine aimed to address this unmet need in care.

Researchers investigated the typical age at which HCC occurs, as well as how early-onset disease responded to treatment. Additionally, according to an article from Carle Illinois College of Medicine, this is the first research to establish a data-driven definition of early-onset HCC, which could potentially lead to more tailored screening and treatment strategies younger adults.

HCC is typically diagnosed later in life, and following the analysis of over 200,000 patient records, investigators identified an age cut-off of under 50 years old as early-onset HCC, becoming the first team to make this validation. Researchers also shared that their definition of the typical onset of HCC was 50 years and over. Making this distinction could have significant implications for future early-detection guidelines, according to researchers, who also said that diagnosing the disease early could improve patient survival rates.

“Innovation in oncology starts with asking the right clinical questions,” Dr. Claudius Conrad, senior author of the study, said in an article detailing the research. “We wanted to understand why early-onset HCC behaves differently and how we can give these younger patients the best possible outcomes.”

Conrad is a member of the Cancer Center at Illinois, as well as a surgical oncologist, and associate dean of Research and Innovation at Carle Illinois College of Medicine.

“The fact that early-onset HCC is declining even as other gastrointestinal cancers rise speaks to the success of prevention — but also to the danger of clinical complacency,” she continued. “We must still identify and treat the patients who fall through the cracks.”

More Information Based on the Research

Overall, these investigators found that the incidence of HCC has risen between 2010 and 2019; however, for people under 50, the proportion of cases declined from 6.4% between 2010 and 2014 to 4.1% between 2015 and 2019. This significantly contradicts with the rising incidence of colorectal cancers in young adults and led to a more in-depth examination of the clinical behavior and risk factors linked to early-onset HCC.

Investigators also found that a history of viral hepatitis, liver cirrhosis, excess alcohol use, smoking, and obesity were all found to be risk factors for the development of HCC at any time during someone’s life. Additionally, investigators also identified social factors which may play a role in the early development of HCC. For example, patients who are of minority race, lack insurance, have lower incomes, or live farther from treatment centers face a higher likelihood of developing early-onset HCC.

Researchers emphasized that, moving forward, integrating these social determinants with a more comprehensive understanding of the tumor biology and epigenetics (how environmental and behavioral factors influence gene function) of early-onset HCC may form the foundation for effective screening strategies.

However, for those patients who have been diagnosed with HCC, that surgery is still a viable route for treatment.

In the same article, Conrad also emphasized that, “Surgery remains the most powerful tool we have for curing HCC. When we catch early-onset cases in time, the liver’s regenerative capacity and overall fitness in younger patients allows us to be aggressive and successful.”

Investigators found that younger patients with HCC, overall, have better outcomes following surgical resection. Therefore, these findings highlight the critical need to identify surgical candidates at an early stage; this is particularly relevant in those with tumors classified as T3 or lower.

“This study is just the beginning. We are entering an era where liver cancer treatment will not only be age-aware, but biology-specific and potentially curable in ways we couldn’t have imagined a decade ago,” Conrad concluded.

References

1. “Study Sheds Light on Frequency, Treatment of Common Liver Cancer in Younger Patients,” by Cancer Center at Illinois. June 26, 2025. https://cancer.illinois.edu/study-sheds-light-on-frequency-treatment-of-common-liver-cancer-in-younger-patients/
2. “Are More Young, Western Patients Also Developing Hepatocellular Carcinoma?” by Dr. Daniel S. Cheah, et al. Annals of Surgical Oncology.

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