Regional variations in hepatocellular carcinoma incidence, routes to diagnosis, treatment and survival in England

Burton, Anya, Balachandrakumar, Vinay K ORCID: 0000-0002-8906-2747, Driver, Robert J, Tataru, Daniela, Paley, Lizz, Marshall, Aileen, Alexander, Graeme, Rowe, Ian A, Palmer, Daniel H ORCID: 0000-0002-7147-5703 and Cross, Tim JS
(2022) Regional variations in hepatocellular carcinoma incidence, routes to diagnosis, treatment and survival in England. BRITISH JOURNAL OF CANCER, 126 (5). pp. 804-814.

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<h4>Background</h4>Hepatocellular carcinoma (HCC) incidence, management and survival across England were examined to determine if geographical inequalities exist.<h4>Method</h4>15,468 HCC cases diagnosed 2010-2016 were included. Age-standardised incidence rates, net survival and proportions receiving potentially curative treatment and presenting through each route to diagnosis adjusted for age at diagnosis, sex and area-based deprivation quintile, were calculated overall and by Cancer Alliance.<h4>Results</h4>HCC incidence rates increased in men from 6.2 per 100,000 in 2010 to 8.8 in 2016, and in women from 1.5 to 2.2. The highest incidence rates, found in parts of the North of England and London, were nearly double the lowest. The adjusted proportion presenting as an emergency ranged 27-41% across Cancer Alliances. Odds increased with increasing deprivation quintile and age. Only one in five patients received potentially curative treatment (range 15-28%) and odds decreased with increasing deprivation and age. One-year survival in 2013-2016 ranged 38-53%.<h4>Conclusion</h4>This population-based, nationwide analysis demonstrates clear differences in HCC incidence, management and survival across England. It highlights socioeconomic-associated variation and the need for improvement in early diagnosis and curative treatment of HCC. This research should assist policymakers, service providers and clinicians to identify regions where additional training, services and resources would be best directed.

Item Type: Article
Uncontrolled Keywords: HCC-UK/BASL/NCRAS Partnership, Humans, Carcinoma, Hepatocellular, Liver Neoplasms, Incidence, Survival Analysis, Age of Onset, Sex Characteristics, Algorithms, Socioeconomic Factors, Aged, Middle Aged, Disease Management, England, Female, Male
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Systems, Molecular and Integrative Biology
Depositing User: Symplectic Admin
Date Deposited: 25 May 2022 09:09
Last Modified: 18 Jan 2023 21:01
DOI: 10.1038/s41416-021-01509-4
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