Epidemiology

Demographic variations seen in liver cancer incidence in US

Last Updated: 2008-07-09 15:19:37 -0400 (Reuters Health)

NEW YORK (Reuters Health) - The incidence of hepatocellular carcinoma in the US differs significantly by sex, ethnicity, and age at diagnosis, according to results of a study published in the June issue of the American Journal of Medicine.

"The increasing incidence of hepatocellular carcinoma coupled with this cancer's high mortality is a public health problem," write Dr. Robert Wong, of the University of California, San Francisco, and colleagues. "Current clinical guidelines recommend initiating hepatocellular carcinoma screening in some high-risk groups, but little data are available in the United States regarding how cancer incidence may differ by age and race/ethnicity."

The team used data from the Surveillance, Epidemiology, and End Results program, a population-based cancer registry, to examine the age-specific, sex-specific, and race-specific variability of hepatocellular carcinoma incidence from 1992 to 2004.

A total of 18,442 cases of hepatocellular carcinoma were identified. When males and females were combined, the team found that Asians had nearly twice the incidence rate of white Hispanics (11.0 versus 6.8 per 100,000/y; p < 0.0001) and more than four times that of Caucasians (11.0 versus 2.6 per 100,000/y; p < 0.0001).

Males had a doubling of cancer rates every 10 years from 30 to 50 years of age, according to the authors. "Females reached male-comparable rates of cancer 10 to 15 years later, and they peaked at significantly lower values for all race/ethnic groups," the team found.

"The possibility that groups with similar identifiable risk factors can present with significantly different disease risk suggests that, if screening is effective, an individualized approach may more efficiently identify treatable tumors than more general guidelines, while minimizing interventions on patients with relatively lower risks of progressing to cancer," Dr. Wong's team concludes.

They add, "More studies are needed to determine disease-specific variations in cancer risks (e.g., hepatitis B and C) and whether incorporating the variations observed into surveillance protocols is clinically efficacious."

Am J Med 2008-121:525-531.