A record-linkage study of the development of hepatocellular carcinoma in persons with hepatitis C infection in Scotland.
We investigated trends in first-time hospital admissions and deaths attributable to hepatocellular carcinoma (HCC) in a large population-based cohort of 22 073 individuals diagnosed with hepatitis C viral (HCV) infection through laboratory testing in Scotland in 1991-2006. We identified new cases of HCC through record-linkage to the national inpatient hospital discharge database and deaths registry. A total of 172 persons diagnosed with HCV were admitted to hospital or died with first-time mention of HCC. Hepatocellular carcinoma incidence increased between 1996 and 2006 (average annual change of 6.1, 95% confidence interval (CI): 0.9-11.6%, P=0.021). The adjusted relative risk of HCC was greater for males (hazard ratio=2.7, 95% CI: 1.7-4.2), for those aged 60 years or older (hazard ratio=2.7, 95% CI: 1.9-4.1) compared with 50-59 years, and for those with a previous alcohol-related hospital admission (hazard ratio=2.5, 95% CI: 1.7-3.7). The risk of individuals diagnosed with HCV developing HCC was greatly increased compared with the general Scottish population (standardised incidence ratio=127, 95% CI: 102-156). Owing to the advancing age of the Scottish HCV-diagnosed population, the annual number of HCC cases is projected to increase, with a consequent increasing burden on the public healthcare system.
McDonald
S A
SA
Health Protection Scotland, Clifton House, Clifton Place, Glasgow G3 7LN, UK. scott.mcdonald@hps.scot.nhs.uk
Hutchinson
S J
SJ
Bird
S M
SM
Robertson
C
C
Mills
P R
PR
Dillon
J F
JF
Goldberg
D J
DJ
D006528:Carcinoma, Hepatocellular / Q000473:pathology*; D015331:Cohort Studies; D006526:Hepatitis C / Q000473:pathology*; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology*; D008498:Medical Record Linkage; D008875:Middle Aged; D012307:Risk Factors; D012606:Scotland