Age- and sex-adjusted hepatocellular carcinoma incidence significantly increased from 5.39 per 100,000 person-years in 2010-2013 to 8.17 per 100,000 person-years in 2018-2021.
Cohort
In a Midwestern US population, HCC incidence significantly increased from 2010 to 2021, driven by metabolic risk factors, older age, and male sex, while overall survival remained low.
Absolute Event Rate: 8.17% vs 5.39%
p-value: p=1.1844x10-4
Objectives/Goals: Hepatocellular carcinoma (HCC) is the third leading cause of cancer deaths worldwide. The epidemiology of HCC has been changing over the past several decades. The aim of this study is to examine changes in etiology, incidence, and survival of HCC in a population-based cohort in the Upper Midwest. Methods/Study Population: The Rochester Epidemiology Project (REP) is a medical records linkage system between healthcare systems that centralizes patient records to a database for investigators to access for approved research projects. The REP now includes 27 counties in southeastern Minnesota and western Wisconsin, with access to 2.9 million medical records linked to 1.4 million persons who resided in this region at some point between 2010-2024. In this study, we used ICD-9 and ICD-10 codes to identify any patient in the REP with one or more instances of the relevant HCC codes. Charts were manually reviewed to confirm diagnosis, residency, and clinical information. All patient data were analyzed as an overall cohort and stratified by era of diagnosis or demographic characteristics. Results/Anticipated Results: Metabolic disorders were the most prevalent HCC risk factor in this cohort, with hypertension, nonalcoholic steatohepatitis, and hyperlipidemia rates significantly increasing over the study period. Age- and sex-adjusted HCC incidence also increased over the study period from 5.39 (95% CI: 3.63, 7.98) per 100,000 person-years in 2010-2013 to 8.17 (95% CI: 6.10, 11.07) per 100,000 person-years in 2018-2021 (p=1.1844x10-4). Age, sex, and race stratification shows that this increase was driven by men, those age 65+ years, and non-Hispanic White individuals. The median survival in this cohort was 23.41 (95% CI: 19.81, 26.97) months, with surveillance status, BCLC stage at diagnosis, hypertension, and hypertriglyceridemia being associated with a significantly decreased hazard ratio of death. Discussion/Significance of Impact: This study highlights the changing landscape of HCC etiology and increasing incidence using a population-based Midwestern cohort. Overall survival remains low, highlighting the need for more robust prevention and screening in at-risk groups.
Lith et al. (Wed,) conducted a cohort in Hepatocellular carcinoma. Time period 2018-2021 vs. Time period 2010-2013 was evaluated on Age- and sex-adjusted HCC incidence per 100,000 person-years (p=1.1844x10-4). Age- and sex-adjusted hepatocellular carcinoma incidence significantly increased from 5.39 per 100,000 person-years in 2010-2013 to 8.17 per 100,000 person-years in 2018-2021.