Christopher Parker1, Steven Y C Tong2, Karen Dempsey3, John Condon2, Suresh K Sharma4, John W C Chen5, William Sievert6, Joshua S Davis2. 1. Menzies School of Health Research, Darwin, NT, Australia. joshua.davis@menzies.edu.au. 2. Menzies School of Health Research, Darwin, NT, Australia. 3. Health Gains Planning Unit, Northern Territory Government, Darwin, NT, Australia. 4. Royal Darwin Hospital, Darwin, NT, Australia. 5. South Australian Liver Transplant Unit, Flinders Medical Centre, Adelaide, SA, Australia. 6. Monash Medical Centre, Melbourne, VIC, Australia.
Abstract
OBJECTIVE: To describe the epidemiology, clinical features, management and outcomes of hepatocellular carcinoma (HCC) in the Northern Territory over the past decade. DESIGN, SETTING AND PATIENTS: An NT-wide epidemiology study covering the period 1991-2010 and a clinical cohort study including patients diagnosed during 2000-2011. HCC diagnoses were provided by the NT Cancer Registry and cross-checked against clinical records. MAIN OUTCOME MEASURES: Age-adjusted incidence of HCC; management; clinical features; and median and 1-year survival. RESULTS: There were 145 incident cases of HCC in the NT during 1991-2010, giving an age-adjusted annual incidence of 22.7/100 000 (95% CI, 17.2-26.8) for Indigenous Australians and 4.0/100 000 (95% CI, 2.1-5.8) for non-Indigenous Australians - an incidence rate ratio of 5.9 (95% CI, 4.7-7.4). There was no significant change in annual age-adjusted incidence over this period. The most common causative factors were hepatitis B virus in Indigenous people and hepatitis C virus in non-Indigenous people. Most people were diagnosed late, only 13/80 were diagnosed by screening, and outcomes were poor, with 28/80 overall surviving to 1 year. Outcomes were better among those managed through a centralised multidisciplinary service than among those who were not (adjusted hazard ratio for death at 1 year, 0.35 [95% CI, 0.16-0.81]). CONCLUSION: HCC incidence remains high in the Indigenous people of the NT. More resources are needed for HCC surveillance and management programs in this population.
OBJECTIVE: To describe the epidemiology, clinical features, management and outcomes of hepatocellular carcinoma (HCC) in the Northern Territory over the past decade. DESIGN, SETTING AND PATIENTS: An NT-wide epidemiology study covering the period 1991-2010 and a clinical cohort study including patients diagnosed during 2000-2011. HCC diagnoses were provided by the NT Cancer Registry and cross-checked against clinical records. MAIN OUTCOME MEASURES: Age-adjusted incidence of HCC; management; clinical features; and median and 1-year survival. RESULTS: There were 145 incident cases of HCC in the NT during 1991-2010, giving an age-adjusted annual incidence of 22.7/100 000 (95% CI, 17.2-26.8) for Indigenous Australians and 4.0/100 000 (95% CI, 2.1-5.8) for non-Indigenous Australians - an incidence rate ratio of 5.9 (95% CI, 4.7-7.4). There was no significant change in annual age-adjusted incidence over this period. The most common causative factors were hepatitis B virus in Indigenous people and hepatitis C virus in non-Indigenous people. Most people were diagnosed late, only 13/80 were diagnosed by screening, and outcomes were poor, with 28/80 overall surviving to 1 year. Outcomes were better among those managed through a centralised multidisciplinary service than among those who were not (adjusted hazard ratio for death at 1 year, 0.35 [95% CI, 0.16-0.81]). CONCLUSION:HCC incidence remains high in the Indigenous people of the NT. More resources are needed for HCC surveillance and management programs in this population.
Authors: Jane Davies; Emma L Smith; Margaret Littlejohn; Rosalind Edwards; Vitina Sozzi; Kathy Jackson; Katie Mcguire; Paula Binks; Benjamin C Cowie; Stephen Locarnini; Joshua S Davis; Steven Y C Tong Journal: Open Forum Infect Dis Date: 2019-11-03 Impact factor: 3.835
Authors: Peter A Revill; Thomas Tu; Hans J Netter; Lilly K W Yuen; Stephen A Locarnini; Margaret Littlejohn Journal: Nat Rev Gastroenterol Hepatol Date: 2020-05-28 Impact factor: 46.802
Authors: Alan J Wigg; Sumudu K Narayana; Gunter Hartel; Linda Medlin; Greg Pratt; Elizabeth E Powell; Paul Clark; Jane Davies; Kirsty Campbell; Maree Toombs; Michael Larkin; Patricia C Valery Journal: EClinicalMedicine Date: 2021-06-07
Authors: Jane Davies; Shu Qin Li; Steven Y Tong; Rob W Baird; Miles Beaman; Geoff Higgins; Benjamin C Cowie; John R Condon; Joshua S Davis Journal: PLoS One Date: 2017-09-08 Impact factor: 3.240