Hepatocellular carcinoma in Australia's Northern Territory: high incidence and poor outcome

Christopher Parker, Steven Y C Tong, Karen Dempsey, John Condon, Suresh K Sharma, John W C Chen, William Sievert, Joshua S Davis

Research output: Contribution to journalArticleResearchpeer-review

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.
Original languageEnglish
Pages (from-to)470 - 474
Number of pages5
JournalMedical Journal of Australia
Volume201
Issue number8
DOIs
Publication statusPublished - 2014

Cite this

Parker, C., Tong, S. Y. C., Dempsey, K., Condon, J., Sharma, S. K., Chen, J. W. C., ... Davis, J. S. (2014). Hepatocellular carcinoma in Australia's Northern Territory: high incidence and poor outcome. Medical Journal of Australia, 201(8), 470 - 474. https://doi.org/10.5694/mja13.11117
Parker, Christopher ; Tong, Steven Y C ; Dempsey, Karen ; Condon, John ; Sharma, Suresh K ; Chen, John W C ; Sievert, William ; Davis, Joshua S. / Hepatocellular carcinoma in Australia's Northern Territory: high incidence and poor outcome. In: Medical Journal of Australia. 2014 ; Vol. 201, No. 8. pp. 470 - 474.
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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.",
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Parker, C, Tong, SYC, Dempsey, K, Condon, J, Sharma, SK, Chen, JWC, Sievert, W & Davis, JS 2014, 'Hepatocellular carcinoma in Australia's Northern Territory: high incidence and poor outcome' Medical Journal of Australia, vol. 201, no. 8, pp. 470 - 474. https://doi.org/10.5694/mja13.11117

Hepatocellular carcinoma in Australia's Northern Territory: high incidence and poor outcome. / Parker, Christopher; Tong, Steven Y C; Dempsey, Karen; Condon, John; Sharma, Suresh K; Chen, John W C; Sievert, William; Davis, Joshua S.

In: Medical Journal of Australia, Vol. 201, No. 8, 2014, p. 470 - 474.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - Hepatocellular carcinoma in Australia's Northern Territory: high incidence and poor outcome

AU - Parker, Christopher

AU - Tong, Steven Y C

AU - Dempsey, Karen

AU - Condon, John

AU - Sharma, Suresh K

AU - Chen, John W C

AU - Sievert, William

AU - Davis, Joshua S

PY - 2014

Y1 - 2014

N2 - 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.

AB - 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.

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U2 - 10.5694/mja13.11117

DO - 10.5694/mja13.11117

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