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 language | English |
|---|---|
| Pages (from-to) | 470-474 |
| Number of pages | 5 |
| Journal | Medical Journal of Australia |
| Volume | 201 |
| Issue number | 8 |
| DOIs | |
| Publication status | Published - 20 Oct 2014 |
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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 journal › Article › Research › peer-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.
KW - sorafenib
KW - adult
KW - aged
KW - alpha fetoprotein blood level
KW - Article
KW - Australia
KW - cancer incidence
KW - cancer risk
KW - cancer survival
KW - chemoembolization
KW - clinical feature
KW - disease surveillance
KW - echography
KW - female
KW - hepatitis B
KW - hepatitis C
KW - human
KW - liver cell carcinoma
KW - liver cirrhosis
KW - liver transplantation
KW - major clinical study
KW - male
KW - medical record
KW - medical record review
KW - outcome assessment
KW - palliative therapy
KW - radiofrequency ablation
KW - retrospective study
KW - seroprevalence
KW - age distribution
KW - cancer staging
KW - Carcinoma, Hepatocellular
KW - epidemiology
KW - follow up
KW - incidence
KW - Liver Neoplasms
KW - middle aged
KW - multimodality cancer therapy
KW - pathology
KW - procedures
KW - prognosis
KW - risk assessment
KW - risk factor
KW - survival rate
KW - time
KW - trends
KW - Age Distribution
KW - Aged
KW - Combined Modality Therapy
KW - Female
KW - Follow-Up Studies
KW - Humans
KW - Incidence
KW - Male
KW - Middle Aged
KW - Neoplasm Staging
KW - Northern Territory
KW - Prognosis
KW - Retrospective Studies
KW - Risk Assessment
KW - Risk Factors
KW - Survival Rate
KW - Time Factors
UR - http://www.scopus.com/inward/record.url?scp=84919336910&partnerID=8YFLogxK
U2 - 10.5694/mja13.11117
DO - 10.5694/mja13.11117
M3 - Article
VL - 201
SP - 470
EP - 474
JO - Medical Journal of Australia
JF - Medical Journal of Australia
SN - 0025-729X
IS - 8
ER -