In this study, physicians identified the cause of the rising incidence of hepatocellular carcinoma in the United States. They assessed whether this increase was due to immigration, an ageing population, or whether it was a true increase among the USA-born residents.
The team evaluated patients in an urban, multiethnic hospital and specialty clinics in a large indigent health system in Houston, Texas.
They included approximately 23,000 admissions and 143,000 out-patient clinic visits each year from 1992 through 2001 in their study.
|Hepatitis C and alcoholic cirrhosis are associated with a majority of cases.|
|Alimentary Pharmacology and Therapeutics|
They selected and reviewed 494 patient records where there was a suspicion of hepatocellular carcinoma.
Hepatocellular carcinoma was confirmed using histopathology, alpha-fetoprotein level >400 ng/mL, and suggestive imaging studies.
The team identified 111 cases of confirmed hepatocellular carcinoma.
They calculated that the age-adjusted incidence rose from 3.44 per 100,000 hospital admissions in 1992 to 1996 to 5.19 in 1997 to 2001.
They also found that the proportion of patients of non-USA place of birth decreased between 1992 to 1996 and 1997 to 2001.
Dr Kulkarni and colleagues concluded, "The incidence of hepatocellular carcinoma within the greater Houston area has increased during the past decade, rising by 51% from 1992-1996 to 1997-2001".
"This increase is not from immigration or population ageing but represents a true rise among the native born population".
"Hepatitis C and alcoholic cirrhosis are associated with a majority of cases, particularly in the latter half of the decade".