美国肝细胞癌（HCC）患者的生存结果提高是以发展非癌症相关的疾病为代价的，例如心血管疾病（CVDs）和感染症。然而，关于HCC患者死因的人群数据还很少。本研究使用美国癌症登记数据库分析了HCC患者的死因。通过死因分布和标准化死亡率计算来量化疾病特异性的死亡负担。在2000年至2018年之间的SEER-18数据库中确定了40,094名诊断为HCC的患者，其中30,796人（76.8％）在随访期间死亡。这些死亡中，大部分（25,153人，81.7％）发生在诊断后的2年内，13.2％（4,075人）在2-5年内发生，5.1％（1,568人）在5年后发生。在研究期间，所有年龄段的女性死亡负担都低于男性。就死因而言，23,824人（77.4％）、2,289人（7.4％）和4,683人（15.2％）死于HCC，其他癌症和非癌症原因。非癌症相关死亡在年龄较大和自诊断以来潜伏期较长的患者中更为普遍。非癌症相关死亡的主要原因是其他感染性和寄生性疾病，包括HIV和心血管疾病。HCC幸存者的死因分布各不相同，并且越来越多的幸存者倾向于死于HCC以外的疾病，潜伏期越长。全面分析死亡模式和时间趋势可以制定降低这些风险的策略。©2023 John Wiley＆Sons Ltd出版的《癌症医学》。

The gains in survival outcomes of US patients with hepatocellular carcinoma (HCC) have come at the expense of developing non-cancer-related morbidities, such as cardiovascular diseases (CVDs) and infections. However, population-based data on causes of death (CODs) in patients with HCC are scarce.A cancer registry database in the United States was used to analyze the CODs among patients with HCC. Death cause distribution and standardized mortality ratios were calculated to quantify the disease-specific death burden.A total of 40,094 patients with a histological diagnosis of HCC were identified from the SEER-18 database between 2000 and 2018, of which 30,796 (76.8%) died during the follow-up period. The majority of these deaths (25,153, 81.7%) occurred within 2 years after diagnosis, 13.2% (4075) occurred within 2-5 years, and 5.1% (1568) occurred after 5 years. All age groups had a lower burden of female deaths than of male deaths during the study period. With respect to CODs, 23,824 (77.4%), 2289 (7.4%), and 4683 (15.2%) were due to HCC, other cancers, and non-cancer causes, respectively. Non-cancer-related deaths were more common among older patients and those with longer latency periods since diagnosis. The major causes of non-cancer-related deaths are other infectious and parasitic diseases, including HIV and CVDs.CODs during HCC survivorship varied, and a growing number of survivors tended to die from causes other than HCC, with an increasing latency period since diagnosis. Comprehensive analyses of mortality patterns and temporal trends could underpin strategies to reduce these risks.© 2023 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.