U.S. sees decrease in HCC disease burden
Incidence of hepatocellular carcinoma (HCC) decreased sharply by 2.3% annually after 2011, while incidence-based mortality saw a 3.2% annual decrease after 2013, according to a study based on national data.
Incidence of and deaths from hepatocellular carcinoma (HCC) have decreased in the U.S. since 2013 while survival has increased, a recent study found.
Researchers used Surveillance, Epidemiology, and End Results data to evaluate HCC incidence, incidence-based mortality, and one-year survival rates in the U.S. from 1992 through 2017. They analyzed secular trends using the National Cancer Institute's Joinpoint Regression Program and evaluated observed temporal trends in age-period-cohort analyses. They used data from the Global Burden of Disease study on HCC incidence and mortality in the U.S. as a likely validation set. The results of the study were published Jan. 24 by Hepatology.
Overall, 50,018 incident HCC cases and 39,792 HCC-related deaths occurred during the study period. Incidence of HCC increased during 1992-2011 but then decreased sharply by 2.3% (95% CI, 1.1% to 3.5%) annually. The incidence-based mortality increased continuously by 3.5% per year from 1993-2013, peaked in 2013 (age-standardized mortality rate, 6.98 per 100,000 person-years), and then began to decrease significantly by 3.2% (95% CI, 1.1% to 5.4%) per year. One-year HCC survival improved from 21.4% to 56.6% during the study period. HCC incidence and mortality risk were highest in patients ages 60 to 69 years who were born between 1952 and 1957.
The authors concluded that overall HCC incidence and HCC-specific mortality have decreased in the U.S. since 2013 and that survival has continuously improved. This decrease in disease burden could be due to changing etiologies, advances in screening and diagnosis, and improved treatment modality and allocation, they noted, but could be thwarted in the future if such efforts and others are not maintained. In particular, the authors said, care must be taken to “prevent metabolic syndrome, reduce the prevalence of alcoholism and injection drug use in the young generation, remove [hepatitis C virus] from blood supply, increase the uptake for [hepatitis B virus] vaccination, and improve treatment for hepatitis, cirrhosis, and HCC.”