[Hepatocellular carcinoma: rising incidence of hepatitis C virus-associated cases at a university clinic in Germany].
OBJECTIVE
Hepatocellular carcinoma (HCC) ranks eighth among malignant tumors worldwide. Western countries belong to areas of low HCC prevalence, but incidence of HCC is rising. The aim of the present, retrospective study was to determine changes in the incidence rates and risk factors for HCC in Germany based on the data of a single center.


METHODS
Epidemiological data of 205 consecutive patients with HCC (163 males, 42 females, mean age 64+/-1 years), admitted to the University clinic Düsseldorf between January 1988 and December 2001, were evaluated. For comparison this time period was divided into two equal intervals (1988 - 1994 and 1995 - 2001).


RESULTS
The number of newly diagnosed HCC has more than doubled in the years 1995 - 2001 compared to the years 1988 - 1994. Chronic hepatitis C (HCV), hepatitis B (HBV), and chronic alcohol abuse accounted for almost 80 % of HCC. The number of HCV-associated HCC increased from 31.0 % in the years 1990 - 1995 to 44.6 % (p < 0.04) in the years 1996 - 2001, whereas the proportion of HBV-associated HCC decreased. There were no changes in the Okuda tumor stage, tumor diameter and alpha-fetoprotein levels at the time of HCC diagnosis throughout the years 1988 - 2001. More than 65 % of HCC were non-resectable at the time of HCC diagnosis due to tumor diameter or number of tumor lesions.


CONCLUSIONS
Screening for HCC, possibly rising in its incidence, should be further improved, taking into account that chronic HCV infection is the major risk factor for HCC in Germany.
Erhardt
A
A
Klinik für Gastroenterologie, Hepatologie und Infektiologiem, Germany. erhardt@uni-duesseldorf.de
Theobald
I
I
Petry
W
W
Röhrborn
A
A
Heintges
T
T
Wettstein
M
M
Häussinger
D
D
D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology* / Q000209:etiology; D003430:Cross-Sectional Studies; D005260:Female; D005858:Germany / Q000453:epidemiology; D019694:Hepatitis B, Chronic / Q000150:complications / Q000453:epidemiology; D019698:Hepatitis C, Chronic / Q000150:complications / Q000453:epidemiology*; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors