Hucke, F.; Emmer, H.; Emmer, R.; Hucke, M.; Bota, S.; Fürstner, M.; Hausegger, K.; Mittermair, R.; Peck-Radosavljevic, M. Changes in the Epidemiology of Hepatocellular Carcinoma in Carinthia, Austria, 2012–2023. Cancers2023, 15, 5215.
Hucke, F.; Emmer, H.; Emmer, R.; Hucke, M.; Bota, S.; Fürstner, M.; Hausegger, K.; Mittermair, R.; Peck-Radosavljevic, M. Changes in the Epidemiology of Hepatocellular Carcinoma in Carinthia, Austria, 2012–2023. Cancers 2023, 15, 5215.
Hucke, F.; Emmer, H.; Emmer, R.; Hucke, M.; Bota, S.; Fürstner, M.; Hausegger, K.; Mittermair, R.; Peck-Radosavljevic, M. Changes in the Epidemiology of Hepatocellular Carcinoma in Carinthia, Austria, 2012–2023. Cancers2023, 15, 5215.
Hucke, F.; Emmer, H.; Emmer, R.; Hucke, M.; Bota, S.; Fürstner, M.; Hausegger, K.; Mittermair, R.; Peck-Radosavljevic, M. Changes in the Epidemiology of Hepatocellular Carcinoma in Carinthia, Austria, 2012–2023. Cancers 2023, 15, 5215.
Abstract
Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related deaths and remains a major burden on health-care systems worldwide. The incidence of HCC continues to rise globally, despite preventative efforts being made. Aims: This study aimed to investigate epidemiological changes observed in the aetiology and survival outcomes of HCC patients at Klinikum Klagenfurt am Wörthersee between 2012 and 2023. Methods: This was a retrospective, single-centre cohort observational study. Two time-periods (2012-2017 and 2018-2023) were created to enable comparison between the respective intervals. Results: More patients were diagnosed with HCC during the second time-period, proving that the incidence of HCC is rising or the referral patterns changing. The median age of diagnosis was 72.5 years (SD 8.6). Patients were on average 2 years younger in the second time-period compared to the first (p = 0.042). Alcohol remained the leading underlying aetiology of HCC and no statistically significant change was seen over time (p = 0.353). Nevertheless, a clear upward trend in the number of NASH cases was evident over time (n = 15, n = 28 respectively). Nearly half of the patient population did not have a raised AFP at the time of diagnosis. The survival time for HCC patients remained similar between time-periods, with a median overall survival time of 20.5 months (95% CI 16.8-24.2, p = 0.841), despite improvements in management strategies and the availability of new systemic treatments but more advanced stage HCC was documented in the second period. An increasing number of HCC patients without liver cirrhosis were identified during the second time-period (n = 22, n= 47 respectively, p = 0.005). NASH was the most common underlying aetiology in patients without liver cirrhosis (50%), compared to alcohol use in being the primary cause in cirrhotic patients (p < 0.001). Conclusion: HCC continues to be an important health concern in our society. The number of HCC patients without liver cirrhosis is steadily increasing, with NAFLD/ NASH, due to underlying life-style diseases playing an important aetiological role. Continued efforts should be made to prevent HCC and to screen at-risk population groups. Preventative strategies and screening techniques should be adjusted in light of the changing epidemiological landscape of HCC.
Keywords
Hepatocellular Carcinoma; survival HCC; epidemiology; NASH; Austria
Subject
Medicine and Pharmacology, Gastroenterology and Hepatology
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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