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HCC incidence may be underreported in Victoria, Australia

Hepatocellular carcinoma incidence in Melbourne, Australia was twofold higher compared with reports found in the Victoria Cancer Registry — a population-based registry that includes the population of Melbourne — suggesting hepatocellular carcinoma is underreported in this region, according to data published in Hepatology.

“Accurate and current epidemiology informs policy decisions by government concerning health resource utilization, identifies risk factors for HCC, and provides targets for prevention,” Thai P. Hong, MBBS, FRACP, of the department of gastroenterology, St. Vincent’s Hospital, Australia, and colleagues wrote. “In Victoria, Australia, we hypothesized that HCC incidence rates may be higher than currently reported by the cancer registry, owning to incorrect classification of clinically diagnosed cases, and incomplete capture from nonreported sources.”

To test this hypothesis, the researchers performed the first population-based study in Australia to investigate HCC incidence. They identified and evaluated all cases of reported HCC from the population of Melbourne, Australia between 2012 and 2013. Researchers found the cases via records of admissions to any of Melbourne's seven tertiary hospitals; attendances at outpatient clinics; as well as radiology, pathology and pharmacy services.

They then compared the cases from the Melbourne population with incidence rates from the Victorian Cancer Registry for the same population and period.

The researchers identified 272 incident cases of HCC (79% men); 83% of whom had cirrhosis. The most common etiologies present for HCC and cirrhosis were hepatitis C virus infection (41%), alcohol (39%) and hepatitis B virus infection (22%). The Victoria Cancer Registry only identified 138 cases.

HCC incidence was 10.3 per 100,000 persons among men (95% CI, 9-11.7) and 2.3 per 100,000 persons among women (95% CI, 1.8-3). The Victorian Cancer Registry reported lower rates for HCC among men (5.3 per 100,000 persons; 95% CI, 4.4-6.4) and women (1 per 100,000 persons; 95% CI, 0.7-1.5; P < .0001).

“The data demonstrate the importance of using current diagnostic criteria for registry classification of HCC in cancer registries,” the researchers wrote. – by Melinda Stevens

Disclosure: Hong reports no The researchers report no relevant financial disclosures. Please see the full study for a list of all other researchers’ relevant financial disclosures.