Trends in incidence of hepatocellular carcinoma after diagnosis of hepatitis B or C infection: a population-based cohort study, 1992–2007

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http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2893.2011.01440.x/abstract

Trends in incidence of hepatocellular carcinoma after diagnosis of hepatitis B

or C infection: a population-based cohort study, 1992–2007

H.-H. Thein1,2,3, S. R. Walter1, H. F. Gidding1, J. Amin1, M. G. Law1, J.

4, G. J. Dore1,5

Article first published online: 17 FEB 2011

DOI: 10.1111/j.1365-2893.2011.01440.x

© 2011 Blackwell Publishing Ltd

Issue

Journal of Viral Hepatitis

Early View (Articles online in advance of print)

Summary.  Chronic hepatitis B virus (HBV) and hepatitis C virus (HCV)

infections are the major risk factors for hepatocellular carcinoma (HCC). We

examined trends in the incidence of HCC among a population-based cohort of

people infected with HBV or HCV. HBV and HCV cases notified to the New South

Wales Health Department between 1992 and 2007 were linked to the Central Cancer

Registry, Registry of Births, Deaths and Marriages, and National HIV/AIDS

Registries. Crude HCC incidence rates were estimated using person-time

methodology. Age-standardized incidence rates were calculated using the 2001

Australian population. Trends in incidence were examined using join point

regression models. Between 1992 and 2007, 1201 people had a linked HCC record:

556 of those with HBV; 592 with HCV; 45 with HBV/HCV co-infection; and 8 with

HIV co-infection. The overall age-standardized HCC incidence rates declined

non-significantly from 148.0 (95% confidence intervals (CI) 63.7, 287.4) per 100

000 population in 1995 to 101.2 (95% CI 67.3, 144.6) in 2007 among the HBV

monoinfected group and significantly from 151.8 (95% CI 62.4, 299.8) per 100 000

population to 75.3 (95% CI 50.8, 105.5) among the HCV monoinfected group.

However, incidence rates in the HCV monoinfected group progressively increased

from the period 1992–1997 to 2004–2007 when adjusted for age, sex, and birth

cohort, and the total number of cases per annum continued to increase. Despite

declines in the age-adjusted incidence rates of HCC over time, the absolute

number of cases increased likely due to the ageing cohort and an increasing

prevalence of both hepatitis B and C in Australia.