D'Or Institute for Research and Education (IDOR), Botafogo, Rio de Janeiro 22281-100, Brazil.
Quinta D'Or Hospital, São Cristóvão, Rio de Janeiro 20941-150, Brazil.
Medicine (Baltimore). 2022 Sep 23;101(38):e30614. doi: 10.1097/MD.0000000000030614.
The incidence of hepatocellular carcinoma (HCC) is increasing globally, and HCC is the fourth leading cause of cancer-related death. This ecological study aimed to investigate the time trends and geographic distribution of HCC in Brazil. Data from the Brazilian Health Public System were retrospectively collected from January 2005 to December 2018. Hospitalization and intrahospital lethality rates for HCC were stratified by age and sex. Hospitalization rates and associated lethality per 100,000 inhabitants in each municipality were included in a worksheet to build maps displaying the estimates and the geographic distribution of HCC. From 2005 to 2018, a total of 75,466 admissions for HCC were registered and the mean hospitalizations increased from 2.1 to 5.8/100,000 inhabitants (176%). The greatest increase occurred among patients older than 50, particularly in males above 70 years old. Prevalence rates increased throughout the country, with the highest levels detected in the South and Southeast. However, the increase was proportionally higher in the Northeast (377%), especially in municipalities not integrated into metropolitan regions. The HCC lethality rate remained relatively stable in both sexes, ranging from 21% to 25% (19%), but it was higher among older patients. The length of hospital stay did not differ between survivors and nonsurvivors throughout the study period. HCC hospitalizations are rising, particularly above 50 years of age and in rural areas, not paralleled by lethality rates. This suggests ongoing changes in environmental and socioeconomic factors in Brazil.
肝细胞癌（HCC）的发病率在全球范围内呈上升趋势，HCC 是癌症相关死亡的第四大原因。本生态研究旨在调查巴西 HCC 的时间趋势和地理分布。从 2005 年 1 月至 2018 年 12 月，回顾性地从巴西卫生公共系统中收集数据。按年龄和性别对 HCC 的住院和院内病死率进行分层。将每个城市的每 10 万人住院率和相关病死率纳入工作表中，以构建显示 HCC 估计值和地理分布的地图。2005 年至 2018 年期间，共登记了 75466 例 HCC 住院病例，平均住院率从 2.1 例/10 万居民增加到 5.8 例/10 万居民（增加了 176%）。最大的增幅发生在 50 岁以上的患者中，尤其是 70 岁以上的男性。全国的患病率都有所增加，南部和东南部的水平最高。然而，东北部的增幅比例更高（377%），尤其是在未纳入大都市区的城市。男女性 HCC 病死率在整个研究期间保持相对稳定，在 21%至 25%（19%）之间，但在老年患者中更高。住院时间长短在整个研究期间在幸存者和非幸存者之间没有差异。HCC 住院人数正在增加，尤其是在 50 岁以上和农村地区，而病死率没有与之平行。这表明巴西的环境和社会经济因素正在发生变化。
