Hepatocellular carcinoma in Australia’s Northern Territory

high incidence and poor outcome

Christopher Parker, Steven Y C Tong, Karen Dempsey, John Condon, Suresh K. Sharma, John W C Chen, William Sievert, Joshua S. Davis

    Research output: Contribution to journalArticleResearchpeer-review

    Abstract

    Objective: To describe the epidemiology, clinical features, management and outcomes of hepatocellular carcinoma (HCC) in the Northern Territory over the past decade.

    Design, setting and patients: An NT-wide epidemiology study covering the period 1991–2010 and a clinical cohort study including patients diagnosed during 2000–2011. HCC diagnoses were provided by the NT Cancer Registry and cross-checked against clinical records.

    Main outcome measures:
     Age-adjusted incidence of HCC; management; clinical features; and median and 1-year survival.

    Results: There were 145 incident cases of HCC in the NT during 1991–2010, giving an age-adjusted annual incidence of 22.7/100 000 (95% CI, 17.2–26.8) for Indigenous Australians and 4.0/100 000 (95% CI, 2.1–5.8) for non-Indigenous Australians — an incidence rate ratio of 5.9 (95% CI, 4.7–7.4). There was no significant change in annual age-adjusted incidence over this period. The most common causative factors were hepatitis B virus in Indigenous people and hepatitis C virus in non-Indigenous people. Most people were diagnosed late, only 13/80 were diagnosed by screening, and outcomes were poor, with 28/80 overall surviving to 1 year. Outcomes were better among those managed through a centralised multidisciplinary service than among those who were not (adjusted hazard ratio for death at 1 year, 0.35 [95% CI, 0.16–0.81]).

    Conclusion: HCC incidence remains high in the Indigenous people of the NT. More resources are needed for HCC surveillance and management programs in this population.

    Original languageEnglish
    Pages (from-to)470-474
    Number of pages5
    JournalMedical Journal of Australia
    Volume201
    Issue number8
    DOIs
    Publication statusPublished - 20 Oct 2014

    Fingerprint

    Northern Territory
    Hepatocellular Carcinoma
    Incidence
    Epidemiology
    Population Control
    Hepatitis B virus
    Hepacivirus
    Registries
    Cohort Studies
    Outcome Assessment (Health Care)
    Survival

    Cite this

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    title = "Hepatocellular carcinoma in Australia’s Northern Territory: high incidence and poor outcome",
    abstract = "Objective: To describe the epidemiology, clinical features, management and outcomes of hepatocellular carcinoma (HCC) in the Northern Territory over the past decade.Design, setting and patients: An NT-wide epidemiology study covering the period 1991–2010 and a clinical cohort study including patients diagnosed during 2000–2011. HCC diagnoses were provided by the NT Cancer Registry and cross-checked against clinical records.Main outcome measures: Age-adjusted incidence of HCC; management; clinical features; and median and 1-year survival.Results: There were 145 incident cases of HCC in the NT during 1991–2010, giving an age-adjusted annual incidence of 22.7/100 000 (95{\%} CI, 17.2–26.8) for Indigenous Australians and 4.0/100 000 (95{\%} CI, 2.1–5.8) for non-Indigenous Australians — an incidence rate ratio of 5.9 (95{\%} CI, 4.7–7.4). There was no significant change in annual age-adjusted incidence over this period. The most common causative factors were hepatitis B virus in Indigenous people and hepatitis C virus in non-Indigenous people. Most people were diagnosed late, only 13/80 were diagnosed by screening, and outcomes were poor, with 28/80 overall surviving to 1 year. Outcomes were better among those managed through a centralised multidisciplinary service than among those who were not (adjusted hazard ratio for death at 1 year, 0.35 [95{\%} CI, 0.16–0.81]).Conclusion: HCC incidence remains high in the Indigenous people of the NT. More resources are needed for HCC surveillance and management programs in this population.",
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    author = "Christopher Parker and Tong, {Steven Y C} and Karen Dempsey and John Condon and Sharma, {Suresh K.} and Chen, {John W C} and William Sievert and Davis, {Joshua S.}",
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    Hepatocellular carcinoma in Australia’s Northern Territory : high incidence and poor outcome. / Parker, Christopher; Tong, Steven Y C; Dempsey, Karen; Condon, John; Sharma, Suresh K.; Chen, John W C; Sievert, William; Davis, Joshua S.

    In: Medical Journal of Australia, Vol. 201, No. 8, 20.10.2014, p. 470-474.

    Research output: Contribution to journalArticleResearchpeer-review

    TY - JOUR

    T1 - Hepatocellular carcinoma in Australia’s Northern Territory

    T2 - high incidence and poor outcome

    AU - Parker, Christopher

    AU - Tong, Steven Y C

    AU - Dempsey, Karen

    AU - Condon, John

    AU - Sharma, Suresh K.

    AU - Chen, John W C

    AU - Sievert, William

    AU - Davis, Joshua S.

    PY - 2014/10/20

    Y1 - 2014/10/20

    N2 - Objective: To describe the epidemiology, clinical features, management and outcomes of hepatocellular carcinoma (HCC) in the Northern Territory over the past decade.Design, setting and patients: An NT-wide epidemiology study covering the period 1991–2010 and a clinical cohort study including patients diagnosed during 2000–2011. HCC diagnoses were provided by the NT Cancer Registry and cross-checked against clinical records.Main outcome measures: Age-adjusted incidence of HCC; management; clinical features; and median and 1-year survival.Results: There were 145 incident cases of HCC in the NT during 1991–2010, giving an age-adjusted annual incidence of 22.7/100 000 (95% CI, 17.2–26.8) for Indigenous Australians and 4.0/100 000 (95% CI, 2.1–5.8) for non-Indigenous Australians — an incidence rate ratio of 5.9 (95% CI, 4.7–7.4). There was no significant change in annual age-adjusted incidence over this period. The most common causative factors were hepatitis B virus in Indigenous people and hepatitis C virus in non-Indigenous people. Most people were diagnosed late, only 13/80 were diagnosed by screening, and outcomes were poor, with 28/80 overall surviving to 1 year. Outcomes were better among those managed through a centralised multidisciplinary service than among those who were not (adjusted hazard ratio for death at 1 year, 0.35 [95% CI, 0.16–0.81]).Conclusion: HCC incidence remains high in the Indigenous people of the NT. More resources are needed for HCC surveillance and management programs in this population.

    AB - Objective: To describe the epidemiology, clinical features, management and outcomes of hepatocellular carcinoma (HCC) in the Northern Territory over the past decade.Design, setting and patients: An NT-wide epidemiology study covering the period 1991–2010 and a clinical cohort study including patients diagnosed during 2000–2011. HCC diagnoses were provided by the NT Cancer Registry and cross-checked against clinical records.Main outcome measures: Age-adjusted incidence of HCC; management; clinical features; and median and 1-year survival.Results: There were 145 incident cases of HCC in the NT during 1991–2010, giving an age-adjusted annual incidence of 22.7/100 000 (95% CI, 17.2–26.8) for Indigenous Australians and 4.0/100 000 (95% CI, 2.1–5.8) for non-Indigenous Australians — an incidence rate ratio of 5.9 (95% CI, 4.7–7.4). There was no significant change in annual age-adjusted incidence over this period. The most common causative factors were hepatitis B virus in Indigenous people and hepatitis C virus in non-Indigenous people. Most people were diagnosed late, only 13/80 were diagnosed by screening, and outcomes were poor, with 28/80 overall surviving to 1 year. Outcomes were better among those managed through a centralised multidisciplinary service than among those who were not (adjusted hazard ratio for death at 1 year, 0.35 [95% CI, 0.16–0.81]).Conclusion: HCC incidence remains high in the Indigenous people of the NT. More resources are needed for HCC surveillance and management programs in this population.

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    KW - echography

    KW - female

    KW - hepatitis B

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    KW - incidence

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