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Title: Hepatocellular carcinoma in Australia's Northern Territory: high incidence and poor outcome.
Authors: Parker, Christopher
Tong, Steven Y C
Dempsey, Karen
Condon, John
Sharma, Suresh K
Chen, John W C
Sievert, William
Davis, Joshua S
Affiliation: Menzies School of Health Research, Darwin, NT, Australia.
Menzies School of Health Research, Darwin, NT, Australia..
Health Gains Planning Unit, Northern Territory Government, Darwin, NT, Australia..
Menzies School of Health Research, Darwin, NT, Australia..
Royal Darwin Hospital, Darwin, NT, Australia..
South Australian Liver Transplant Unit, Flinders Medical Centre, Adelaide, SA, Australia..
Monash Medical Centre, Melbourne, VIC, Australia..
Menzies School of Health Research, Darwin, NT, Australia..
Issue Date: 20-Oct-2014
Citation: The Medical journal of Australia 2014-10-20; 201(8): 470-4
Abstract: To describe the epidemiology, clinical features, management and outcomes of hepatocellular carcinoma (HCC) in the Northern Territory over the past decade. 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. Age-adjusted incidence of HCC; management; clinical features; and median and 1-year survival. 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]). HCC incidence remains high in the Indigenous people of the NT. More resources are needed for HCC surveillance and management programs in this population.
Type: Journal Article
Research Support, Non-U.S. Gov't
Subjects: Age Distribution
Carcinoma, Hepatocellular
Combined Modality Therapy
Follow-Up Studies
Liver Neoplasms
Middle Aged
Neoplasm Staging
Northern Territory
Retrospective Studies
Risk Assessment
Risk Factors
Survival Rate
Time Factors
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