[Increased incidence of hepatocellular and intrahepatic cholangiocellular carcinoma in northeast Germany].
OBJECTIVE
Hepatocellular cancer (HCC) is one of the five most common cancers worldwide. In Western countries the incidence of both HCC and intrahepatic cholangiocellular cancer (iCCC) has increased quite dramatically in the last 20 years. It was the aim of this study to assess the epidemiological changes of both cancers in the Northeast of Germany.


METHODS
Using the data base of the Joint German Cancer Registry of the New Federal States and of Berlin, the age- and world-population-adjusted incidence of HCC and iCCC and their 5-year survival were calculated. The states of Brandenburg, Mecklenburg-Vorpommern and Saxony were chosen for this study because of the high quality of their registration base.


RESULTS
In men the age-adjusted incidence of HCC increased from 3.6 in 1976 to 5.7 in 2002, the absolute number of newly diagnosed HCCs rising from 192 to 383 males within this period. In women the incidence was much lower. While only 30 males and 36 females were diagnosed with iCCC in 1976, in 2002 there were 64 men and 75 women with iCCC. In 1976, the corresponding age-adjusted incidence was 0.5 in men and 0.4 in women. Up to 2002 the incidence of iCCC rose to 0.8 and 0.6, respectively. The cumulative 5-year survival of HCC and iCCC was less than 10% for each. Comparison of the early period (1978-1979) with the later one (1998-1999) demonstrated a statistically significant improvement in survival for HCC. This was most likely due to earlier diagnosis and treatment of HCC.


CONCLUSIONS
In the Northeast of Germany the incidence of both HCC and iCCC have increased markedly in the last 20 years. The recently improved survival of HCC patients most likely reflects earlier diagnosis and treatment.
Schurr
R
R
Medizinische Klinik I, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin.
Stölzel
U
U
Schuppan
D
D
Schwertner
C
C
Steinberg
J
J
Scherübl
H
H
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000453:epidemiology*; D001653:Bile Ducts, Intrahepatic; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology*; D018281:Cholangiocarcinoma / Q000453:epidemiology*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008113:Liver Neoplasms / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D012042:Registries; D017678:Sex Distribution