BACKGROUND & AIMS: The incidence of hepatocellular carcinoma (HCC) has been increasing in the United States. Although resource-intensive treatment modalities have been increasingly applied, these patients still have poor survival. We examined 2 nationally representative databases, the Multiple Cause of Death file and the Nationwide Inpatient Sample database, to examine trends in mortality and hospital service utilization related to HCC. METHODS: In both databases, a priori criteria were used to identify cases of HCC. All other available diagnostic fields were examined to characterize coexistent liver disease. Age-, sex-, and race-specific mortality from HCC was calculated, and temporal changes in mortality rates were evaluated using the multivariable Poisson model. Hospital service utilization was estimated based on length of stay, total hospitalization charges, and principal procedures. RESULTS: The age-, sex-, and race-specific mortality from HCC increased from 1.54 to 2.58 per 100,000 per year between 1980 and 1998. Male sex, African and Asian race, and increasing age were also associated with higher mortality. The estimated total charge for HCC hospitalizations nationwide increased from 241 million US dollars in 1988 to 509 million US dollars in 2000 after inflation adjustment. Commonly employed procedures in 2000 included angiography/embolization, resection, local ablative therapy, and liver transplantation. CONCLUSIONS: In the recent past, mortality and hospital service utilization related to HCC increased substantially. Closer epidemiologic surveillance to understand causation of HCC at the population level and to help implement primary and secondary prevention is urgently warranted.
BACKGROUND & AIMS: The incidence of hepatocellular carcinoma (HCC) has been increasing in the United States. Although resource-intensive treatment modalities have been increasingly applied, these patients still have poor survival. We examined 2 nationally representative databases, the Multiple Cause of Death file and the Nationwide Inpatient Sample database, to examine trends in mortality and hospital service utilization related to HCC. METHODS: In both databases, a priori criteria were used to identify cases of HCC. All other available diagnostic fields were examined to characterize coexistent liver disease. Age-, sex-, and race-specific mortality from HCC was calculated, and temporal changes in mortality rates were evaluated using the multivariable Poisson model. Hospital service utilization was estimated based on length of stay, total hospitalization charges, and principal procedures. RESULTS: The age-, sex-, and race-specific mortality from HCC increased from 1.54 to 2.58 per 100,000 per year between 1980 and 1998. Male sex, African and Asian race, and increasing age were also associated with higher mortality. The estimated total charge for HCC hospitalizations nationwide increased from 241 million US dollars in 1988 to 509 million US dollars in 2000 after inflation adjustment. Commonly employed procedures in 2000 included angiography/embolization, resection, local ablative therapy, and liver transplantation. CONCLUSIONS: In the recent past, mortality and hospital service utilization related to HCC increased substantially. Closer epidemiologic surveillance to understand causation of HCC at the population level and to help implement primary and secondary prevention is urgently warranted.
Authors: Nicholas P Webber; Sunil Sharma; Allie H Grossmann; Akram Shaaban; Kevin B Jones; Lester J Layfield; R Lor Randall Journal: J Clin Oncol Date: 2010-08-16 Impact factor: 44.544
Authors: Ju Dong Yang; W Ray Kim; Kyung Woo Park; Roongruedee Chaiteerakij; Bohyun Kim; Schuyler O Sanderson; Joseph J Larson; Rachel A Pedersen; Terry M Therneau; Gregory J Gores; Lewis R Roberts; Joong-Won Park Journal: Hepatology Date: 2012-07-02 Impact factor: 17.425
Authors: Ju Dong Yang; Bohyun Kim; Schuyler O Sanderson; Jennifer L St Sauver; Barbara P Yawn; Rachel A Pedersen; Joseph J Larson; Terry M Therneau; Lewis R Roberts; W Ray Kim Journal: Mayo Clin Proc Date: 2012-01 Impact factor: 7.616