Background and Aims
Hepatocellular carcinoma (HCC) is the third leading cause of cancer mortality worldwide. This study considers the geographical trends in incidence and mortality from HCC.

Methods
Data were obtained for each EU15+ country from the Global Burden of Disease Study database. Age-standardised incidence rates (ASIRs), mortality rates (ASMRs) and disability-adjusted life years (DALYs) were extracted for each year from 1990 to 2019. Data were subdivided into males and females. Mortality-to-incidence ratios (MIRs) were calculated. All Indices were reported per 100 000 population, and trends were described using Joinpoint regression.

Results
ASIRs increased in 17/19 countries in females and 18/19 countries in males between 1990 and 2019. ASMRs increased in all countries except Italy (for both sexes) and Sweden (for females). MIR decreased in all countries except Denmark in males (+8.0) and females (+1.2). Ireland saw the greatest decline in MIR among females (−15.0%) and the United Kingdom for males (−16.4%). DALYs increased in all countries except Italy for males and females and Sweden for females.

Conclusions
The incidence of and mortality from hepatocellular carcinoma are increasing in the majority of EU15+ countries. The rise in mortality and fall in MIR may suggest that outcomes from HCC are improving, despite an increased disease burden.