Epidemiological trends of hepatocellular carcinoma in Austria.
OBJECTIVE
The heterogeneous epidemiology of hepatocellular carcinoma (HCC) with the highest incidence rates in East Asia, sub-Saharan Africa and Melanesia results from variations in the main risk factors. We investigated epidemiological trends, including incidence and mortality, of patients diagnosed with HCC over a 20-year period in Austria.


METHODS
Data on age-adjusted incidence rates of HCC were obtained from the Austrian National Cancer Registry, which compiles nationwide data on all newly diagnosed cancers. Data on age-adjusted mortality were obtained from the national death registry (Statistics Austria).


RESULTS
Of 24,939 patients diagnosed with hepatobiliary tumors between 1990 and 2009, 8,561 subjects had HCC (m/f ratio 75/25%; mean age 69 years). Lymph node and distant metastases were present in 7.5 and 12.2%, respectively. The age-adjusted incidence rate was significantly higher in men than women (m/f ratio 4.5/1) and markedly increased in men (4.68/5.10) but remained stable in women (1.18/1.11). Similarly, the age-adjusted mortality rate was significantly higher in men than women (m/f ratio 4.5/1), increased in men (4.02/4.98) and remained stable in women (0.92/1.0). The median overall survival was 4.5 months for men and 3.2 months for women with 1-/5-year survival rates of 33/11% and 28/10%, respectively.


CONCLUSIONS
HCC is the most common hepatobiliary neoplasia in Austria and has a very poor prognosis. The age-adjusted incidence and mortality rates were higher in males, increased over time in men and remained stable in women. Extrahepatic metastases were rarely diagnosed and associated with dismal survival.
Division of Gastroenterology and Hepatology and Comprehensive Cancer Center, AKH and Medical University of Vienna, Vienna, Austria.
Matthias
M
Pinter
Florian
F
Hucke
Nadine
N
Zielonke
Michael
M
Trauner
Wolfgang
W
Sieghart
Markus
M
Peck-Radosavljevic
D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001317:Austria / Q000453:epidemiology; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012042:Registries; D012189:Retrospective Studies; D017678:Sex Distribution; D018709:Statistics, Nonparametric; D016019:Survival Analysis