OBJECTIVES: There is large geographic variation in incidence levels and time trends of hepatocellular carcinoma. We compared population-based liver cancer incidence and survival in European and U.S. populations in order to elucidate geographic differences and time trends for these variables. METHODS: Since comparisons based on cancer registry data are problematic because of variations in liver cancer definition and coding, we considered a subset of cases likely to be mainly hepatocellular carcinoma, suitable for international comparison. Incidence and 5-yr relative survival were calculated from cases diagnosed in five European regions (30,423 cases) and the United States (6,976 cases) in 1982-1994. RESULTS: Age-standardized incidence was highest in southern Europe (12/100,000 in men and 3/100,000 in women in 1992-94) and lowest in northern Europe, where incidence was similar to that of the United States (3/100,000 in men, <1/100,000 in women). Over the study period, incidence remained stable in the United States and most of Europe, except for a notable increase in southern Europe. Five-year relative survival was <10% in Europe, ranging from 8% (southern Europe) to 5% (eastern Europe), and 6% in the United States. Survival increased slightly with time, mainly in southern Europe and was unaffected by sex, but was better in younger patients. CONCLUSIONS: Increasing incidence in southern Europe is probably related to hepatitis B and C infection and increasing alcohol intake, while improving survival may be due to greater surveillance for cirrhosis. The survival gap between clinical and population-based series suggests management is better in centers of excellence. © 2007 by Am. Coll. of Gastroenterology.
Hepatocellular carcinoma: Trends of incidence and survival in Europe and the United States at the end of the 20th century / Capocaccia, R.; Sant, M.; Berrino, F.; Simonetti, A.; Santi, V.; Trevisani, F.; Oberaigner, W.; Jechova, M.; Rousarova, M.; Storm, H. H.; Aareleid, T.; Hakulinen, T.; Hedelin, G.; Tron, I.; Le Gall, E.; Launoy, G.; Mace-Lesech, J.; Faivre, J.; Chaplain, G.; Carli, P. M.; Danzon, A.; Tretarre, B.; Colonna, M.; Lacour, B.; Raverdy, N.; Berger, C.; Freycon, F.; Grosclaude, P.; Esteve, J.; Kaatsch, P.; Ziegler, H.; Holzel, D.; Schubert Fritschle, G.; Tryggvadottir, L.; Allemani, C.; Baili, P.; Ciccolallo, L.; Gatta, G.; Micheli, A.; Taussig, E.; Carrani, E.; De Angelis, R.; Hartley, S.; Roazzi, P.; Santaquilani, M.; Tavilla, A.; Valente, F.; Verdecchia, A.; Ferretti, S.; Crosignani, P.; Contiero, P.; Ramazzotti, V.; Vercelli, M.; Quaglia, A.; Pannelli, F.; Vitarelli, S.; Mosciatti, P.; Federico, M.; Artioli, M. E.; Ponz De Leon, M.; Benatti, P.; De Lisi, V.; Serventi, L.; Zanetti, R.; Patriarca, S.; Magnani, C.; Pastore, G.; Gafa, L.; Tumino, R.; Falcini, F.; Budroni, M.; Paci, E.; Crocetti, E.; Zambon, P.; Guzzinati, S.; Dalmas, M.; Langmark, F.; Andersen, A.; Rachtan, J.; Bielska-Lasota, M.; Wronkowski, Z.; Zwierko, M.; Pinheiro, P. S.; Pleko, I.; Obsitnikova, A.; Pompe-Kirn, V.; Izarzugaza, I.; Martinez-Garcia, C.; Garau, I.; Navarro, C.; Chirlaque, M. D.; Ardanaz, E.; Moreno, C.; Galceran, J.; Torrella, A.; Peris-Bonet, R.; Barlow, L.; Moller, T.; Jundt, G.; Lutz, J. -M.; Usel, M.; Coebergh, J. W. W.; Van Der Does-Van Den Berg, A.; Visser, O.; Godward, S.; Coleman, M. P.; Williams, E. M. I.; Forman, D.; Quinn, M. J.; Roche, M.; Edwards, S.; Stiller, S.; Verne, J.; Moller, H.; Bell, J.; Botha, J. L.; Lawrence, G.; Black, R.; Brewster, D.; Steward, J. A.. - In: THE AMERICAN JOURNAL OF GASTROENTEROLOGY. - ISSN 0002-9270. - 102:8(2007), pp. 1661-1670. [10.1111/j.1572-0241.2007.01337.x]
Hepatocellular carcinoma: Trends of incidence and survival in Europe and the United States at the end of the 20th century
Ponz De Leon M.;Benatti P.;
2007
Abstract
OBJECTIVES: There is large geographic variation in incidence levels and time trends of hepatocellular carcinoma. We compared population-based liver cancer incidence and survival in European and U.S. populations in order to elucidate geographic differences and time trends for these variables. METHODS: Since comparisons based on cancer registry data are problematic because of variations in liver cancer definition and coding, we considered a subset of cases likely to be mainly hepatocellular carcinoma, suitable for international comparison. Incidence and 5-yr relative survival were calculated from cases diagnosed in five European regions (30,423 cases) and the United States (6,976 cases) in 1982-1994. RESULTS: Age-standardized incidence was highest in southern Europe (12/100,000 in men and 3/100,000 in women in 1992-94) and lowest in northern Europe, where incidence was similar to that of the United States (3/100,000 in men, <1/100,000 in women). Over the study period, incidence remained stable in the United States and most of Europe, except for a notable increase in southern Europe. Five-year relative survival was <10% in Europe, ranging from 8% (southern Europe) to 5% (eastern Europe), and 6% in the United States. Survival increased slightly with time, mainly in southern Europe and was unaffected by sex, but was better in younger patients. CONCLUSIONS: Increasing incidence in southern Europe is probably related to hepatitis B and C infection and increasing alcohol intake, while improving survival may be due to greater surveillance for cirrhosis. The survival gap between clinical and population-based series suggests management is better in centers of excellence. © 2007 by Am. Coll. of Gastroenterology.
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