美国肝癌发病率已达峰值了吗？
Have incidence rates of liver cancer peaked in the United States?
作者信息
Petrick Jessica L, Florio Andrea A, Loomba Rohit, McGlynn Katherine A
机构信息
Slone Epidemiology Center, Boston University, Boston, Massachusetts.
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland.
出版信息
Cancer. 2020 Jul 1;126(13):3151-3155. doi: 10.1002/cncr.32794. Epub 2020 Apr 15.
BACKGROUND
Liver cancer incidence has increased for several decades in the United States. Recently, reports have suggested that rates of hepatocellular carcinoma (HCC), the dominant form of liver cancer, had declined in certain groups. However, to the authors' knowledge, the most recent histology-specific liver cancer rates have not been reported to date.
METHODS
The authors examined the incidence of HCC and intrahepatic cholangiocarcinoma (ICC) from 1992 through 2016 using data from the Surveillance, Epidemiology, and End Results registries. Age-standardized incidence rates were calculated by histology, sex, race and/or ethnicity, and age. Trends were analyzed using the National Cancer Institute's Joinpoint Regression Program to estimate the annual percent change.
RESULTS
Between 2011 and 2016, HCC rates significantly declined (annual percent change, -1.9%), with more prominent declines noted among males, Asian/Pacific Islanders, and individuals aged <50 years. Conversely, ICC rates increased from 2002 through 2016.
CONCLUSIONS
Declining HCC rates may persist due to improved treatment of the hepatitis C virus and/or competing causes of mortality among individuals with fatty liver disease.
背景
在美国，肝癌发病率几十年来一直在上升。最近，有报告表明，肝癌的主要形式肝细胞癌（HCC）在某些群体中的发病率有所下降。然而，据作者所知，目前尚未报告最新的组织学特异性肝癌发病率。
方法
作者利用监测、流行病学和最终结果登记处的数据，研究了1992年至2016年期间肝细胞癌（HCC）和肝内胆管癌（ICC）的发病率。按组织学、性别、种族和/或族裔以及年龄计算年龄标准化发病率。使用美国国家癌症研究所的Joinpoint回归程序分析趋势，以估计年度变化百分比。
结果
2011年至2016年间，肝细胞癌发病率显著下降（年度变化百分比，-1.9%），男性、亚太岛民和年龄<50岁的个体下降更为明显。相反，2002年至2016年间肝内胆管癌发病率上升。
结论
由于丙型肝炎病毒治疗的改善和/或脂肪肝疾病患者中其他竞争性死亡原因，肝细胞癌发病率下降可能会持续。
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