Kusnik Alexander, Najim Mostafa, Renjith Keerthi Mannumbeth, Vyas Charmee, Renjithlal Sarath Lal Mannumbeth, Alweis Richard
Department of Internal Medicine, Unity Hospital, Rochester, NY, USA.
Division of Palliative Care, University of Kentucky, Lexington, KY, USA.
Gastroenterology Res. 2024 Jun;17(3):116-125. doi: 10.14740/gr1743. Epub 2024 Jun 29.
Hepatocellular carcinoma (HCC) remains one of the leading causes of cancer-related fatalities despite early diagnosis and treatment progress, creating a significant public health issue in the United States. This investigation utilized death certificate data from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) database to investigate HCC mortality patterns and death locations from 1999 to 2020. The objective was to analyze trends in HCC mortality across different population groups, considering the impact of urbanicity.
In this study, death certificate data obtained from the CDC WONDER database were utilized to investigate the trends in HCC mortality and location of death between 1999 and 2020. The annual percent change (APC) method was applied to estimate the average annual rate of change during the specified timeframe for the relevant health outcome. Furthermore, including data on the location of death and geographic areas allowed us to gain deeper insights into the patterns and characteristics of HCC and its impact on different regions.
Between 1999 and 2020, there were 184,073 reported deaths attributed to HCC, and data on the location of death were available for all cases. Most deaths occurred during inpatient admissions (34.93%) or at home (41.19%). The study also found that the highest age-adjusted mortality rate (AAMR) for HCC was observed among male patients, particularly among those identified as Asian or Pacific Islander. Variations in AAMR were determined based on the level of urbanization or rurality of the area, with higher rates observed in more densely populated and urbanized regions. In contrast, less urbanized and populated areas experienced a profound increase in AAMR over the past two decades.
The HCC-related AAMRs have worsened over time for most ethnic groups, except for Asian or Pacific Islanders, which showed a reduction in APC despite having the worst AAMR. Although rural and less densely populated areas have substantially increased AAMR over the past two decades, more urbanized areas continued to have higher AAMR rates.
尽管在早期诊断和治疗方面取得了进展，但肝细胞癌（HCC）仍然是癌症相关死亡的主要原因之一，在美国引发了重大的公共卫生问题。本研究利用疾病控制与预防中心广泛在线流行病学研究数据（CDC WONDER）数据库中的死亡证明数据，调查1999年至2020年期间HCC的死亡模式和死亡地点。目的是分析不同人群中HCC死亡率的趋势，并考虑城市化的影响。
在本研究中，利用从CDC WONDER数据库获得的死亡证明数据，调查1999年至2020年期间HCC的死亡率趋势和死亡地点。应用年度百分比变化（APC）方法来估计特定时间段内相关健康结果的年均变化率。此外，纳入死亡地点和地理区域的数据使我们能够更深入地了解HCC的模式和特征及其对不同地区的影响。
1999年至2020年期间，报告了184,073例归因于HCC的死亡病例，所有病例均有死亡地点数据。大多数死亡发生在住院期间（34.93%）或家中（41.19%）。研究还发现，男性患者中观察到HCC的最高年龄调整死亡率（AAMR），尤其是那些被认定为亚裔或太平洋岛民的男性。AAMR的差异是根据该地区的城市化或农村程度确定的，在人口更密集和城市化程度更高的地区观察到更高的比率。相比之下，在过去二十年中，城市化程度较低和人口较少的地区AAMR有显著增加。
除亚裔或太平洋岛民外，大多数种族的HCC相关AAMR随时间推移有所恶化，尽管亚裔或太平洋岛民的AAMR最差，但APC有所下降。尽管在过去二十年中农村和人口较少的地区AAMR大幅增加，但城市化程度更高的地区AAMR仍然更高。
