Rate of Primary Liver Cancer Type Still Climbing

Rate of Primary Liver Cancer Type Still Climbing
MedPage Today
Published: May 06, 2010

Rates of hepatocellular carcinoma in the U.S. continue to increase, according to the CDC.

From 2001 to 2006, the rate of the disease rose from 2.7 per 100,000 to 3.2 (P<0.01), CDC researchers reported in the May 7 issue of Morbidity and Mortality Weekly Report.

The largest annual percentage changes occurred in whites (3.8%), blacks (4.8%), and individuals in their 50s (9.1%).

Cases increased for both genders, although the annual percentage change was significantly higher in men (3.6% versus 2.3%, P&l t;0.05).

The findings indicate that long-term increases in cases of hepatocellular carcinoma -- of which more than three-quarters are caused by infection with hepatitis B or hepatitis C virus -- continue, according to the researchers.

"Development of viral hepatitis services, including screening with care referral for persons chronically infected with HBV or HCV, full implementation of vaccine-based strategies to eliminate hepatitis B, and improved public health surveillance are needed to help reverse the trend in hepatocellular carcinoma," they wrote.

The researchers analyzed data from the CDC's National Program of Cancer Registries and the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) surveillance system.

Only microscopically con firmed cases of hepatocellular carcinoma were included, which, according to an accompanying comment from the MMWR editors, likely yielded more conservative estimates than previous analyses.

From 2001 to 2006, there were 48,596 cases identified, with a median age of 64 at diagnosis (62 for males and 69 for females).

The average annual rate of hepatocellular carcinoma was 3.0 per 100,000. It increased by 3.5% a year.

Individuals in their 70s were most affected, with a rate of 13.7 per 100,000, followed by those in their 80s (10.0), 60s (9.6), 50s (6.8), and 40s (2.1). Cases were infrequent in the younger age groups.

The incidence rate during the study period was about three times higher in males th an in females (5.0 versus 1.3 per 100,000), with a larger annual inc rease in men.

The racial/ethnic group most affected was Asians/Pacific Islanders (7.8 per 100,000), followed by blacks (4.2), American Indians/Alaska natives (3.2), and whites (2.6). Rates increased over the study period for white and black individuals only.

The rate rose for both Hispanic and non-Hispanic individuals, with annual percentage changes of 3.6% and 1.7%, respectively (P<0.05 for both).

The report also provided the first state-specific information on hepatocellular carcinoma trends.

Disease rates ranged from 1.4 per 100,000 in South Dakota to 5.5 in Hawaii. Eleven states had significant increases from 2001 to 2006, with the largest annual percentage changes in Okla homa (11.7%), Iowa (9.0%), and Georgia (7.4%).

The MMWR editors listed three limitations of the analysis, including possible misclassification of race and ethnicity, the lack of national data on specific Asian subgroups, and the fact that cancer registries do not routinely collect information on etiologic factors for hepatocellular carcinoma, including chronic viral hepatitis.

Primary source: Morbidity and Mortality Weekly Report
Source reference:
O'Connor S, et al "Hepatocellular carcinoma -- United States, 2001-2006" MMWR 2010; 59: 517-20.