Cancer and Hematology Centers, Texas Children's Hospital, Houston, TX, United States; Division of Hematology-Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States.
Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, United States.
Cancer Epidemiol. 2024 Oct;92:102610. doi: 10.1016/j.canep.2024.102610. Epub 2024 Jul 9.
Hepatocellular carcinoma accounts for approximately 80 % of liver neoplasms. Globally, hepatocellular carcinoma ranks as the third most lethal cancer, with the number of deaths expected to further increase by 2040. In adults, disparities in incidence and survival are well described while pediatric epidemiology is not well characterized. We describe incidence and survival for pediatric (ages 0-19 years) hepatocellular carcinoma cases and compare these measures to adults (ages ≥ 20 years) diagnosed with hepatocellular carcinoma.
We assessed incidence data from the US Cancer Statistics database during 2003-2020 and 5-year survival from the National Program of Cancer Registries during 2001-2019. Incidence trends were determined by annual percent change (APC) and average APC (AAPC) using joinpoint regression. Five-year survival was evaluated by relative survival, and all-cause survival was estimated using multivariate Cox modeling. Corresponding 95 % confidence intervals (CI) were calculated for all analyses.
Incidence rate per 100,000 persons was 0.056 (95 %CI:0.052-0.060) for pediatric cases and 7.793 (7.767-7.819) for adults. Incidence was stable in the pediatric population (0.3 AAPC, - 1.1 to 1.7). In contrast, after periods of increase, incidence declined in adults after 2015 (-1.5 APC). Relative survival increased over time for both pediatric and adult ages and was higher for children and adolescents (46.4 %, 95 %CI:42.4-50.3) than adults (20.7 %, 95 %CI:20.5-20.9). Regression modeling showed that non-Hispanic Black race and ethnicity was associated with higher risk of death in children and adolescents (1.48, 95 %CI:1.07-2.05) and adults (1.11, 95 %CI:1.09-1.12) compared to non-Hispanic white race and ethnicity.
Between 2003 and 2020 in the United States, pediatric incidence was stable while incidence in adults began to decline after 2015. Survival was higher across all stages for children and adolescents compared to adults. Non-Hispanic Black race and ethnicity showed a higher risk of death for both age groups. Further studies could explore the factors that influence these outcome disparities.
肝细胞癌约占肝脏肿瘤的 80%。在全球范围内，肝细胞癌是第三大最致命的癌症，预计到 2040 年死亡人数将进一步增加。在成年人中，发病率和生存率的差异已得到充分描述，而儿科流行病学特征尚不清楚。我们描述了儿童（0-19 岁）肝细胞癌病例的发病率和生存率，并将这些指标与成年（≥20 岁）肝细胞癌患者进行了比较。
我们评估了 2003 年至 2020 年期间美国癌症统计数据库中的发病率数据，以及 2001 年至 2019 年期间国家癌症登记计划中的 5 年生存率。发病率趋势通过年度百分比变化（APC）和平均 APC（AAPC）使用连接点回归来确定。通过相对生存率评估 5 年生存率，使用多变量 Cox 模型估计全因生存率。所有分析均计算了相应的 95%置信区间（CI）。
儿童病例的发病率为每 10 万人 0.056（95%CI：0.052-0.060），而成年人的发病率为 7.793（7.767-7.819）。儿童人群的发病率保持稳定（0.3 AAPC，-1.1 至 1.7）。相比之下，成年人的发病率在 2015 年后呈下降趋势（-1.5 APC），此前经历了一段时间的增长。儿童和青少年的相对生存率随着时间的推移而提高，高于成年人（46.4%，95%CI：42.4-50.3）。回归模型显示，与非西班牙裔白人种族和民族相比，非西班牙裔黑人种族和民族与儿童和青少年（1.48，95%CI：1.07-2.05）和成年人（1.11，95%CI：1.09-1.12）的死亡风险更高。
在 2003 年至 2020 年期间，美国儿童的发病率保持稳定，而成年人的发病率在 2015 年后开始下降。与成年人相比，儿童和青少年在所有阶段的生存率都更高。非西班牙裔黑人种族和民族在两个年龄组中都显示出更高的死亡风险。进一步的研究可以探讨影响这些结果差异的因素。
