Liver cancer has a significant impact on global health. Taiwan is a country with a high incidence rate of liver cancer. Efforts in primary prevention and treatment of chronic hepatitis B and C are projected to decrease the liver cancer incidence in Taiwan. We used the Taiwan Cancer Registry data to explore the time trend of liver cancer incidence over the last decade, which showed a decreasing trend of 21% in males and 26.1% in females from 2009 to 2018. Both genders aged 30-39 years had the

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... atest decrease in liver cancer incidence, while those >70 years old had the least decrease. Our study also showed gender disparity in liver cancer with a persistent male predominance over time. In the past decade, the liver cancer incidence had a 2.5 to 2.7 sex ratio (male to female) and varied gender differences at different ages. Sex ratios peaked at age 40-49 years and gradually decreased as age increases. The pattern of age-specific gender differences was similar between 2009 and 2018. This finding implies that female sex hormones may play a protective role in the development of liver cancer.