Liver cancer and hepatitis B and C in New South Wales, 1990-2002: a linkage study.
OBJECTIVE
Hepatocellular carcinoma (HCC) incidence has increased in Australia in the past 20-30 years. We conducted a community-based linkage study to examine the characteristics of hepatocellular carcinoma with particular reference to hepatitis B and C infections.


METHODS
Hepatocellular carcinoma cases (n=2,072) notified to the New South Wales (NSW) Central Cancer Registry from 1990 to 2002 were probabilistically linked to HBV and HCV diagnoses notified to NSW Health. Sex, age, year of diagnosis, region of birth, method of diagnosis and spread at diagnosis and survival were compared by linkage group.


RESULTS
Hepatocellular carcinoma incidence increased from 1.4/100,000 in 1990 to 2.8/100,000 in 2002. Incidence varied by region of birth (p<0.001), with people born in Vietnam having the highest relative rate compared with those born in Australia (RR=11.7, 95% CI 9.8-13.8). Of the hepatocellular carcinoma records, 15.6%, 12.9% and 0.8% were linked to hepatitis B, hepatitis C and hepatitis B/C co-infection respectively and 70.7% were unlinked. Median age at diagnosis of HCV-related hepatocellular carcinoma varied markedly at 51, 68 and 71 years for Australian, European, and Asian-born groups, respectively (p<0.0001).


CONCLUSIONS
Contrasting age distribution of HCV-related HCC by country/region of birth is consistent with divergent patterns of HCV transmission.


CONCLUSIONS
These data highlight the increase in HCC in NSW and the divergent populations whose needs in terms of treatment, care and prevention will need to be met.
Amin
Janaki
J
National Centre in HIV Epidemiology and Clinical Research, University of New South Wales. jamin@nchecr.unsw.edu.au
O'Connell
Dianne
D
Bartlett
Mark
M
Tracey
Elizabeth
E
Kaldor
John
J
Law
Matthew
M
Dore
Gregory
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006509:Hepatitis B / Q000175:diagnosis / Q000453:epidemiology*; D006526:Hepatitis C / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008113:Liver Neoplasms / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009517:New South Wales / Q000453:epidemiology; D012042:Registries; D012189:Retrospective Studies; D015996:Survival Rate