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Incidence of hepatocellular carcinoma among older Americans attributable to hepatitis C and hepatitis B: 2001 through 2013
Author(s) -
Shiels Meredith S.,
Engels Eric A.,
Yanik Elizabeth L.,
McGlynn Katherine A.,
Pfeiffer Ruth M.,
O’Brien Thomas R.
Publication year - 2019
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.32129
Subject(s) - medicine , hepatocellular carcinoma , incidence (geometry) , population , hepatitis b virus , hepatitis c , epidemiology , hepatitis c virus , hepatitis b , liver cancer , gastroenterology , immunology , virus , environmental health , physics , optics
Background In the United States, incidence and mortality rates of hepatocellular carcinoma (HCC) are increasing in older individuals. Chronic infection with hepatitis C virus (HCV) and hepatitis B virus (HBV) are important causes of HCC; however, the contribution of viral hepatitis to recent trends in HCC incidence among older Americans is unclear. Methods Data from the Surveillance, Epidemiology, and End Results–Medicare linkage (SEER‐Medicare) for the years 2001 through 2013 were used to identify HCC cases among individuals aged ≥66 years and Medicare files were used to assess the HCV and HBV status of these HCC cases. Age‐standardized incidence rates of HCV‐attributable, HBV‐attributable, and HCV/HBV‐unrelated HCC were estimated overall and by age group, sex, and race/ethnicity. The authors also calculated annual percent changes (APCs) in HCC incidence. Results Between 2001 and 2013, a total of 15,300 HCC cases occurred in this population. Overall HCC rates increased 43% from 16.3 to 23.3 per 100,000 population (APC, 3.40% per year), whereas HCV‐attributable HCC rates nearly doubled from 4.2 to 8.2 per 100,000 population (APC, 5.62% per year). HCC rates increased more slowly for HBV‐attributable HCC (1.3 to 1.8 per 100,000 population; APC, 3.17% per year) and HCV/HBV‐unrelated HCC (11.3 to 14.1 per 100,000 population; APC, 2.35% per year). The percentage of HCC cases with evidence of HCV infection increased from 25.7% in 2001 through 2004 to 32.3% in 2011 through 2013, whereas the percentage with HBV remained stable at 8%. In 2013, higher rates for both HCV‐attributable and HBV‐attributable HCC were noted among individuals aged 66 to 75 years, men, and individuals of Asian ancestry. Conclusions Among Americans aged ≥66 years, HCC rates increased rapidly between 2001 and 2013. Although HCV‐attributable cases contributed substantially to this increase, rates of HBV‐attributable and HCV/HBV‐unrelated HCC also rose during this period.