■西欧原发性肝癌(PLC)的发病率正在增加。为了了解英国的长期趋势和当前的负担,对PLC及其亚型的流行病学进行了详细分析.
■1997-2017年诊断的PLC数据来自基于人群的数据,在英国全国注册。欧洲年龄标准化发病率(ASR)和基于发病率的死亡率(ASMR)每100,000人年的总体计算,并按性别和英国国家计算。使用Joinpoint回归估计费率的年度百分比变化。一个-,2-,并估计了5岁的标准化净生存率。
■共诊断出82,024个PLC。肝细胞癌(HCC)发病率和死亡率均增加了三倍(每100,000ASR1.8-5.5,ASMR1.3-4.0)。增长率在2014/2015年左右似乎趋于平稳。苏格兰男性的HCC发病率一直最高。PLC存活率增加,由HCC(预后优于其他PLC)和HCC生存率(1年生存率变化24-47%)的比例大幅增加驱动。肝内胆管癌是女性最常见的PLC,1年生存率从22.6%提高到30.5%。
■PLC发病率一直在快速增长,但是,由于大多数风险因素是可修改的,它在很大程度上是一种可预防的癌症。这种增长速度近年来有所放缓,可能归因于丙型肝炎的有效治疗。由于肥胖和糖尿病等其他风险因素在英国仍然普遍存在,这种疾病的巨大负担不太可能减轻。虽然生存有所改善,超过一半的患者在1年后无法生存,因此,在预防方面取得了进一步进展,早期发现,和治疗创新是必要的。
■越来越多的人患上肝癌,特别是亚型肝细胞癌,比20年前。苏格兰的男性最有可能患上肝癌并因此死亡。肝癌诊断后的生存期越来越长,但不到一半的人在1年后还活着。
UNASSIGNED: The incidence of primary liver cancer (PLC) is increasing in Western Europe. To understand trends over time and the current burden in the UK, a detailed analysis of the epidemiology of PLC and its subtypes was conducted.
UNASSIGNED: Data on PLCs diagnosed during 1997-2017 were obtained from population-based, nationwide registries in the UK. European age-standardised incidence (ASR) and incidence-based mortality rates (ASMR) per 100,000 person-years were calculated overall and by sex and UK-nation. Annual percentage change in rates was estimated using Joinpoint regression. One-, 2-, and 5-year age-standardised net survival was estimated.
UNASSIGNED: A total of 82,024 PLCs were diagnosed. Both hepatocellular carcinoma (HCC) incidence and mortality rates trebled (ASR 1.8-5.5 per 100,000, ASMR 1.3-4.0). The rate of increase appeared to plateau around 2014/2015. Scottish men consistently had the highest HCC incidence rates. PLC survival increased, driven by a substantial increase in the proportion that are HCC (as prognosis is better than other PLCs) and in HCC survival (change in 1-year survival 24-47%). Intrahepatic cholangiocarcinoma was the most common PLC in women and 1-year survival improved from 22.6% to 30.5%.
UNASSIGNED: PLC incidence has been increasing rapidly but, as most risk factors are modifiable, it is largely a preventable cancer. This rate of increase has slowed in recent years, possibly attributable to effective treatment for hepatitis C. As other risk factors such as obesity and diabetes remain prevalent in the UK, it is unlikely the considerable burden of this disease will abate. While improvements in survival have been made, over half of patients are not alive after 1 year, therefore further progress in prevention, early detection, and treatment innovation are needed.
UNASSIGNED: Many more people are getting liver cancer, particularly the subtype hepatocellular carcinoma, than 20 years ago. Men in Scotland are most likely to get liver cancer and to die from it. Survival after liver cancer diagnosis is getting longer but still less than half are alive after 1 year.