Liver cancer deaths in the United States have doubled since the mid-1980s. This year alone the disease will account for an estimated 41,000 new diagnoses and 29,000 deaths among Americans, according to a new American Cancer Society study released this week, WTOP reports.

The study also found that Washington, DC, currently has the highest liver cancer rates in the country and that African-American men living in the nation’s capital are four times more likely to die of liver cancer than their white counterparts. Additionally, liver cancer incidence and death rates appear to be two to threefold higher among men than women in every racial group across the country. 

The diagnostic report—which focused on both national statistics and disparities in liver cancer occurrence by both race/ethnicity and state in the United States—pooled data from 1990 through 2014 via the National Center for Health Statistics and the Centers for Disease Control and Prevention, as provided through the National Cancer Institute’s Surveillance, Epidemiology and End Results (SEER) Program.

Their findings showed that liver cancer incidence is highest among American Indians and Alaska Natives, followed by Asian and Pacific Islanders, Hispanics, African Americans and non-Hispanic whites. Death rates related to liver cancer also followed this pattern, though African Americans had a slightly higher death rate than their Hispanic counterparts. Overall, the report found that only one in five patients overall survived five years after a liver cancer diagnosis.

In terms of state-level analysis, the report showed that after DC, Hawaii, Louisiana, Texas and California have the highest rates of liver cancer in the country. The states with the lowest liver cancer rates are North Dakota, Vermont, Utah, Nebraska and South Dakota. 

The ACS study also noted that the majority—approximately 60 percent—of liver cancer diagnoses in the United States can be attributed to potentially modifiable risk factors. Metabolic disorders, including diabetes, obesity and non-alcoholic fatty liver disease (NAFLD) accounted for the largest proportion (32 percent) of liver cancers in the country, followed by chronic hepatitis C virus (HCV) infection (21 percent), excessive alcohol consumption (13 percent), smoking (9 percent) and chronic hepatitis B virus (HBV) infection (4 percent).

The report goes on to suggest that a substantial number of liver cancer deaths could be averted through targeted prevention, early detection and treatment strategies. Recommendations included making nationwide improvements in hepatitis B virus (HBV) vaccination, increasing screening and treatment for hepatitis C and improving access to high-quality diabetes care and smoking cessation and alcohol abuse programs across the country.