Hepatocellular Carcinoma Incidence, Mortality, and Survival Trends in the United States From 1975 to 2005
Hepatocellular Carcinoma Incidence, Mortality, and Survival Trends in the United States From 1975 to 2005
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DOI：
10.1200/jco.2008.20.7753
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发表时间：
2009-03-20
影响因子：
45.3
通讯作者：
Reichman, Marsha E.
中科院分区：
文献类型：
--
作者：
Altekruse, Sean F.;McGlynn, Katherine A.;Reichman, Marsha E.
目的
肝细胞癌（HCC）是全球癌症死亡的第三大原因。在美国，其发病率正在上升。监测高危人群的发病率、生存率和死亡率有助于防控工作。
方法
对1975年至2005年监测、流行病学和最终结果（SEER）登记处的肝细胞癌年龄调整发病率趋势进行了研究。对1900年至1959年出生的队列按年龄别发病率进行了研究。对1992年至2005年SEER 13个登记处按种族/族裔、分期和治疗的年龄调整发病率和病因别生存率进行了研究。还研究了美国肝癌死亡率。
结果
1975年至2005年，年龄调整后的肝细胞癌发病率增加了两倍。从1900年到20世纪50年代，每10年出生的队列发病率都在上升。亚裔/太平洋岛民的发病率和死亡率高于其他种族/族裔群体，但随着时间推移，其死亡率显著下降。2000年至2005年，西班牙裔、黑人和白人中年男性的发病率显著上升。1992年至2004年，随着更多患者被诊断为局限性和区域性肝细胞癌且预后改善，尤其是有治疗记录的患者，2 - 4年肝细胞癌生存率增加了一倍。然而，近期1年生存率仍低于50%。
结论
肝细胞癌的发病率和死亡率持续上升，尤其是在中年黑人、西班牙裔和白人男性中。对高危人群进行筛查以及对局限性肿瘤进行治疗可能有助于提高美国肝细胞癌的生存率。还需要更多进展。
PurposeHepatocellular carcinoma (HCC) is the third leading cause of cancer mortality worldwide. Incidence rates are increasing in the United States. Monitoring incidence, survival, and mortality rates within at-risk populations can facilitate control efforts.MethodsAge-adjusted incidence trends for HCC were examined in the Surveillance, Epidemiology, and End Results (SEER) registries from 1975 to 2005. Age-specific rates were examined for birth cohorts born between 1900 and 1959. Age-adjusted incidence and cause-specific survival rates from 1992 to 2005 were examined in the SEER 13 registries by race/ethnicity, stage, and treatment. United States liver cancer mortality rates were also examined.ResultsAge-adjusted HCC incidence rates tripled between 1975 and 2005. Incidence rates increased in each 10-year birth cohort from 1900 through the 1950s. Asians/Pacific Islanders had higher incidence and mortality rates than other racial/ethnic groups, but experienced a significant decrease in mortality rates over time. From 2000 to 2005, marked increases in incidence rates occurred among Hispanic, black, and white middle-aged men. Between 1992 and 2004, 2- to 4-year HCC survival rates doubled, as more patients were diagnosed with localized and regional HCC and prognosis improved, particularly for patients with reported treatment. Recent 1-year survival rates remained, however, less than 50%.ConclusionHCC incidence and mortality rates continue to increase, particularly among middle-aged black, Hispanic, and white men. Screening of at-risk groups and treatment of localized-stage tumors may contribute to increasing HCC survival rates in the United States. More progress is needed.