The continuing increase in the incidence of hepatocellular carcinoma in the United States: an update

December 16, 2003

Ann Intern Med. 2003 Nov 18;139(10):817-23.

Summary for patients in:

Ann Intern Med. 2003 Nov 18;139(10):I28.

The continuing increase in the incidence of hepatocellular carcinoma in the

United States: an update.

El-Serag HB, Davila JA, sen NJ, McGlynn KA.

The Houston Center for Quality of Care and Utilization Studies, Sections of

Gastroenterology and Health Services Research at The Houston Veterans

Affairs Medical Center, and Baylor College of Medicine, Houston, Texas

77030, USA. hasheme@...

BACKGROUND: The incidence of hepatocellular carcinoma was reported to be

increasing in the United States. However, alternate explanations were

diagnostic or reclassification bias and changes in the demographic features

of the general population. OBJECTIVE: To examine the temporal trends in the

incidence of hepatocellular carcinoma. DESIGN: Retrospective cohort study.

SETTING: Information collected by population-based registries of the

Surveillance, Epidemiology, and End Results (SEER) program. PATIENTS:

Persons given a diagnosis of hepatocellular carcinoma between 1975 and 1998.

MEASUREMENTS: Linear Poisson multivariate regression model, controlling for

differences in age, sex, race or ethnicity, and geographic region among

patients with hepatocellular carcinoma and in the underlying population.

RESULTS: The overall age-adjusted incidence rates of hepatocellular

carcinoma increased from 1.4 per 100 000 in 1975 to 1977 to 3.0 per 100 000

in 1996 to 1998. There was a 25% increase during the last 3 years of the

study compared with the preceding 3 years (1993 to 1995). The increase

affected most age groups above 40 years, with the greatest increase in the

45- to 49-year-old age group. White men had the greatest increase (31%) in

the last time period (1996 to 1998) compared with 1993 to 1995. The Poisson

regression model confirmed an almost 2-fold increase in the incidence rate

ratio for hepatocellular carcinoma between 1975 to 1978 and 1996 to 1998.

CONCLUSIONS: The incidence of hepatocellular carcinoma continues to increase

rapidly in the United States, with rates increasing the fastest in white men

45 to 54 years of age. These findings are consistent with a true increase

and could be explained by consequences of hepatitis C virus acquired during

the 1960s and 1970s.

PMID: 14623619 [PubMed - indexed for MEDLINE]

December 16, 2003