Melkonian SC, et al. - This study assessed liver cancer occurrence rates and risk factors in non-Hispanic American Indians and Alaska Natives (AI/AN) populations for the years 1999–2009. Using Pearson correlation coefficients, the correlations between regional liver cancer incidence rates and risk factors were evaluated. Overall, AI/AN persons vs whites had higher liver cancer incidence rates, and there was an increasing trend among AI/AN persons. Except Alaska, rates of distant disease were also higher in the AI/AN vs white population for all regions. Alcohol use and obesity were correlated with liver cancer incidence by region.