Hepatocellular Carcinoma Prevalence and Mortality in a Male State Prison Population
Hepatocellular Carcinoma Prevalence and Mortality in a Male State Prison Population
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DOI：
10.1177/003335490912400115
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发表时间：
2009-01-01
影响因子：
3.3
通讯作者：
Raimer, Ben G.
中科院分区：
文献类型：
--
作者：
Baillargen, Jacques;Snyder, Ned;Raimer, Ben G.
目标。过去二十年来，美国肝细胞癌（HCC）的发病率急剧上升，很大程度上是由于晚期丙型肝炎病毒（HCV）感染人数的增加。鉴于美国囚犯 HCV 感染、合并乙型肝炎病毒 (HBV) 感染和酒精性肝病的发生率较高，因此他们患 HCC 的风险很高。我们研究的目的是调查美国最大的州立监狱系统中 HCC 的患病率和死亡率。方法。研究人群包括 2003 年 1 月 1 日至 2006 年 7 月 31 日期间被监禁的 325,477 名德克萨斯州刑事司法部 (TDCJ) 男性囚犯。有关医疗状况和人口特征的信息是从机构范围的医疗信息系统中获得的。结果。在为期 3.5 年的研究期间，176 名 TDCJ 男性囚犯（每 10 万人中 54 人）被诊断患有 HCC，其中 108 人（每 10 万人中 33 人）死于 HCC。感染 HCV、HBV 或人类免疫缺陷病毒的西班牙裔、老年囚犯的 HCC 患病率和死亡率均较高。调整所有研究协变量后，糖尿病囚犯中 HCC 患病率略有升高，但死亡率并未升高。结论。我们的研究表明，德克萨斯州男性监狱人口的 HCC 患病率比美国普通男性人口高七倍，HCC 死亡率高四倍。这些发现可能反映了囚犯中 HCC 相关危险因素（尤其是 HCV）的高度集中。
Objectives. The incidence of hepatocellular carcinoma (HCC) in the United States has increased dramatically over the last two decades, largely because of an increase in the number of people with advanced hepatitis C virus (HCV) infection. U.S. prisoners are at high risk for HCC, given their elevated rates of HCV infection, comorbid hepatitis B virus (HBV) infection, and alcoholic liver disease. The purpose of our study was to examine the prevalence and mortality of HCC in the nation's largest state prison system.Methods. The study population consisted of 325,477 male Texas Department of Criminal Justice (TDCJ) inmates who were incarcerated between January 1, 2003, and July 31, 2006. Information on medical conditions and demographic characteristics was obtained from an institution-wide medical information system.Results. During the 3.5-year study period, 176 male TDCJ inmates (54 per 100,000) were diagnosed with HCC and 108 (33 per 100,000) died as a result of HCC. Inmates who were Hispanic, older, and infected with HCV, HBV, or human immunodeficiency virus had elevated rates of both HCC prevalence and mortality. After adjusting for all study covariates, HCC prevalence, but not mortality, was modestly elevated among inmates with diabetes.Conclusions. Our study showed that the Texas male prison population had a sevenfold higher prevalence of HCC than the general U.S. male population and a fourfold higher death rate from HCC. These findings likely reflect the high concentration of HCC-related risk factors, particularly HCV, among prisoners.