Please use this identifier to cite or link to this item: https://doi.org/10.1002/hep4.1059
Title: Deciphering the Epidemiology of Hepatocellular Carcinoma Through the Passage of Time: A Study of 1,401 Patients Across 3 Decades
Authors: Goh, George Boon-Bee 
Li, James Weiquan 
Chang, Pik-Eu 
Chow, Khuan-Yew
Tan, Chee-Kiat 
Keywords: Science & Technology
Life Sciences & Biomedicine
Gastroenterology & Hepatology
CHRONIC HEPATITIS-B
LIVER-CANCER INCIDENCE
VIRUS INFECTION
NONALCOHOLIC STEATOHEPATITIS
INTERNATIONAL TRENDS
ALCOHOL-CONSUMPTION
HONG-KONG
SINGAPORE
CIRRHOSIS
MANAGEMENT
Issue Date: 1-Aug-2017
Publisher: JOHN WILEY & SONS LTD
Citation: Goh, George Boon-Bee, Li, James Weiquan, Chang, Pik-Eu, Chow, Khuan-Yew, Tan, Chee-Kiat (2017-08-01). Deciphering the Epidemiology of Hepatocellular Carcinoma Through the Passage of Time: A Study of 1,401 Patients Across 3 Decades. HEPATOLOGY COMMUNICATIONS 1 (6) : 564-571. ScholarBank@NUS Repository. https://doi.org/10.1002/hep4.1059
Abstract: Hepatocellular carcinoma (HCC) is one of the most common and lethal cancers globally. With advances in therapy for chronic viral hepatitis, changing social circumstances, and increasing practice of HCC surveillance, the epidemiology of HCC is expected to change over time. We explored the temporal trends in HCC in Singapore, a multiethnic Asian country, over the last 3 decades. Patients with HCC were prospectively enrolled and stratified into two cohorts (C1, 1988-2002; C2, 2003-2016). Patient and tumor characteristics, management, and survival were compared between the two cohorts, and a survival census was performed on October 31, 2015. There were 1,401 patients, and the mean age at diagnosis of HCC for C1 and C2 was 60.1 and 63.5 years, respectively. Male patient preponderance decreased significantly, with the male to female ratio falling from 5.2:1 to 3.9:1 between C1 and C2. Hepatitis B, although still the predominant risk factor for HCC, showed a significant decline from C1 to C2 (76.5% to 68.2%), while the nonviral etiology increased significantly over the same period (14.4% versus 25.0%, respectively). Significantly more patients in C2 than C1 were diagnosed through surveillance (39.2% versus 11.3%, respectively) and had better physical performance (Eastern Cooperative Oncology Group 0, 62.1% versus 20.4%, respectively). While Child-Pugh status was comparable, significantly more patients in C2 than C1 had early stage disease (Barcelona Clinic Liver Cancer 0-A, 39.5% versus 7.4%, respectively), which translated into significantly higher median survival (18.6 months versus 3.8 months, respectively). Conclusion: Over the past 3 decades, hepatitis B-related HCC has been decreasing while HCC due to nonviral etiology has been increasing significantly. Surveillance to diagnose early stage HCC is important in improving the outcome of HCC. (Hepatology Communications 2017;1:564–571).
Source Title: HEPATOLOGY COMMUNICATIONS
URI: https://scholarbank.nus.edu.sg/handle/10635/241714
ISSN: 2471-254X
2471-254X
DOI: 10.1002/hep4.1059
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