Maguire Frances B, Hofer Brenda M, Parikh-Patel Arti, Keegan Theresa H M
California Cancer Reporting and Epidemiologic Surveillance Program, University of California Davis Comprehensive Cancer Center, Sacramento, California.
Center for Oncology Hematology Outcomes Research and Training (COHORT) and Division of Hematology and Oncology, University of California Davis School of Medicine, Sacramento, California.
J Registry Manag. 2024 Winter;51(4):136-145.
Liver cancer is composed of 2 main types, hepatocellular carcinoma (HCC) and cholangiocarcinoma (CCA). After years of increasing HCC incidence rates in the United States, declines have been noted in recent years, but CCA incidence rates have continued increasing. Given these variable trends; documented disparities by sex, age, and race/ethnicity; and shifting risk factors from viral infection (hepatitis B and C) to metabolic causes (obesity, diabetes, nonalcoholic fatty liver disease), we sought to assess the incidence rate trends for HCC and CCA in California to inform whether California trends are similar to those observed in the United States as a whole, whether these trends have continued in the most recent years for which data is available, and to identify at-risk groups that may benefit from targeted intervention.
Using SEER*Stat software, we calculated age-adjusted incidence rates (AAIR) by sex, age group, and race/ethnicity for patients aged ≥40 years diagnosed with HCC and CCA from 2010 to 2021 identified in the California Cancer Registry. We assessed the annual percent change (APC) over this period for each subgroup using Joinpoint software.
For HCC, the AAIR significantly decreased for men (-2.68%) and women (-2.23%) since 2014. Significant decreases were observed for men among all racial/ethnic groups, but among women, decreases were only seen in Black and Asian/Pacific Islander patients. Decreases in AAIR were greatest among those aged 40 to 64 years (men, -7.01%; women, -7.79%) and increases were observed for men aged ≥75 years since 2010 (1.15%). For CCA, the AAIR significantly increased for men aged ≥75 years (2.8%) and for women in all age groups. Only White men had decreasing AAIRs.
HCC AAIR trends have declined in California, but not for all groups. Older men and Hispanic and White women did not experience the same reductions in HCC AAIR observed in other groups. CCA AAIR trends have increased among nearly all groups for women. Future research should focus on evaluating risk factors by liver cancer sub-type, and regular screening of individuals with risk factors should be considered.
肝癌主要由两种类型组成，即肝细胞癌（HCC）和胆管癌（CCA）。在美国，肝细胞癌发病率多年来持续上升，近年来虽有所下降，但胆管癌发病率仍持续上升。鉴于这些不同的趋势、已记录的性别、年龄和种族/族裔差异，以及风险因素从病毒感染（乙型和丙型肝炎）向代谢因素（肥胖、糖尿病、非酒精性脂肪性肝病）的转变，我们试图评估加利福尼亚州肝细胞癌和胆管癌的发病率趋势，以了解加利福尼亚州的趋势是否与美国整体观察到的趋势相似，这些趋势在可获得数据的最近几年是否持续存在，并确定可能从靶向干预中受益的高危人群。
我们使用SEER*Stat软件，计算了2010年至2021年在加利福尼亚癌症登记处确诊的年龄≥40岁的肝细胞癌和胆管癌患者按性别、年龄组和种族/族裔调整后的发病率（AAIR）。我们使用Joinpoint软件评估了这一时期每个亚组的年度百分比变化（APC）。
对于肝细胞癌，自2014年以来，男性（-2.68%）和女性（-2.23%）的年龄调整发病率显著下降。在所有种族/族裔群体中，男性的发病率均显著下降，但在女性中，仅黑人及亚裔/太平洋岛民患者的发病率有所下降。年龄调整发病率的下降在40至64岁人群中最为明显（男性为-7.01%；女性为-7.79%），自2010年以来，75岁及以上男性的发病率有所上升（1.15%）。对于胆管癌，75岁及以上男性的年龄调整发病率显著上升（2.8%），所有年龄组的女性发病率均上升。只有白人男性的年龄调整发病率下降。
加利福尼亚州肝细胞癌的年龄调整发病率趋势有所下降，但并非所有群体都是如此。老年男性以及西班牙裔和白人女性的肝细胞癌年龄调整发病率没有像其他群体那样下降。几乎所有女性群体的胆管癌年龄调整发病率趋势都有所上升。未来的研究应侧重于按肝癌亚型评估风险因素，并应考虑对有风险因素的个体进行定期筛查。
