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. 2017 Sep;51(8):742-748.
doi: 10.1097/MCG.0000000000000810.

Recent Trends in the Epidemiology of Hepatocellular Carcinoma in Olmsted County, Minnesota: A US Population-based Study

Ju Dong Yang  1 , Hager Ahmed Mohammed, William S Harmsen, Felicity Enders, Gregory J Gores, Lewis R Roberts
Affiliations

Recent Trends in the Epidemiology of Hepatocellular Carcinoma in Olmsted County, Minnesota: A US Population-based Study

Ju Dong Yang et al. J Clin Gastroenterol. 2017 Sep.

Abstract

Background/aim: The epidemiology of hepatocellular carcinoma (HCC) has changed in the United States recently. The aim of this study is to evaluate the recent trends of HCC epidemiology in Olmsted County, MN.

Methods: Residents aged over 20 with newly diagnosed HCC were identified using the Rochester Epidemiology Project database. Clinical information was compared among patients diagnosed between 2000 and 2009 (era 1) and 2010 to 2014 (era 2).

Results: Over 1.6 million person years of follow-up, 93 residents were diagnosed with HCC. The mean age was 67 and 71% were male. The age-adjusted and sex-adjusted incidence rates were 6.3 and 7.0 per 100,000 person years in the first and second eras (P=0.64). The proportion with hepatitis B virus etiology increased from 4% to 21% between the 2 eras (P<0.01), whereas there was a trend toward a decreasing proportion of hepatitis C virus etiology from 42% to 29% (P=0.20). Only 39% of HCC surveillance candidates had HCCs detected under surveillance and 41% of cirrhotic patients had unrecognized cirrhosis at the time of HCC diagnosis. Nonalcoholic fatty liver disease was associated with unrecognized cirrhosis and absence of cirrhosis at HCC diagnosis. More than half (56%) of patients presented at Barcelona Clinic Liver Cancer stage C or D and the median survival was 9.7 months. The overall survival had not changed over time.

Conclusions: The incidence of HCC remained stable after 2010 in Olmsted County. The proportion of hepatitis B virus-induced HCC increased, whereas there was a trend of decreasing proportion of hepatitis C virus-induced HCC. The overall survival in community residents with HCC remains poor.

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Conflict of interest statement

Conflict of Interest: Nothing to disclose

Figures

Figure 1
Figure 1
Trends in the risk factors for hepatocellular carcinoma among Olmsted County, Minnesota, residents, 2000–2009 vs. 2010–2014. HBV = hepatitis B virus; HCV = hepatitis C virus; NAFLD = nonalcoholic fatty liver disease
Figure 2
Figure 2
Trends in the survival of Olmsted County, Minnesota, residents with hepatocellular carcinoma, 2000–2009 vs. 2010–2014
Figure 3
Figure 3
Comparison of overall survival of patients with hepatocellular carcinoma detected under surveillance vs. no surveillance
See this image and copyright information in PMC

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