Primary liver cancer in the UK: Incidence, incidence-based mortality, and survival by subtype, sex, and nation

HCC-UK/BASL/NCRAS Partnership Steering Group

doi:10.1016/j.jhepr.2021.100232

Primary liver cancer in the UK: Incidence, incidence-based mortality, and survival by subtype, sex, and nation

HCC-UK/BASL/NCRAS Partnership Steering Group

Research output: Contribution to journal › Article › peer-review

37 Citations (Scopus)

Abstract

Background & Aims: The incidence of primary liver cancer (PLC) is increasing in Western Europe. To understand trends over time and the current burden in the UK, a detailed analysis of the epidemiology of PLC and its subtypes was conducted.

Methods: Data on PLCs diagnosed during 1997-2017 were obtained from population-based, nationwide registries in the UK. European age-standardised incidence (ASR) and incidence-based mortality rates (ASMR) per 100,000 person-years were calculated overall and by sex and UK-nation. Annual percentage change in rates was estimated using Joinpoint regression. One-, 2-, and 5-year age-standardised net survival was estimated.

Results: A total of 82,024 PLCs were diagnosed. Both hepatocellular carcinoma (HCC) incidence and mortality rates trebled (ASR 1.8-5.5 per 100,000, ASMR 1.3-4.0). The rate of increase appeared to plateau around 2014/2015. Scottish men consistently had the highest HCC incidence rates. PLC survival increased, driven by a substantial increase in the proportion that are HCC (as prognosis is better than other PLCs) and in HCC survival (change in 1-year survival 24-47%). Intrahepatic cholangiocarcinoma was the most common PLC in women and 1-year survival improved from 22.6% to 30.5%.

Conclusions: PLC incidence has been increasing rapidly but, as most risk factors are modifiable, it is largely a preventable cancer. This rate of increase has slowed in recent years, possibly attributable to effective treatment for hepatitis C. As other risk factors such as obesity and diabetes remain prevalent in the UK, it is unlikely the considerable burden of this disease will abate. While improvements in survival have been made, over half of patients are not alive after 1 year, therefore further progress in prevention, early detection, and treatment innovation are needed.

Lay summary: Many more people are getting liver cancer, particularly the subtype hepatocellular carcinoma, than 20 years ago. Men in Scotland are most likely to get liver cancer and to die from it. Survival after liver cancer diagnosis is getting longer but still less than half are alive after 1 year. Crown Copyright (C) 2021 Published by Elsevier B.V. on behalf of European Association for the Study of the Liver (EASL).

Original language	English
Article number	100232
Number of pages	11
Journal	JHEP Reports
Volume	3
Issue number	2
DOIs	https://doi.org/10.1016/j.jhepr.2021.100232
Publication status	Published - Apr 2021

Bibliographical note

Funding Information:
HCC-UK BASL/NCRAS Partnership Steering Group: Anya Burton, Aileen Marshall, Graeme Alexander, Ian Rowe, Robert J. Driver, Vinay Kumar, Tim Cross, Katherine Cullen, Rhys Pockett, Tom Bird, Dyfed W. Huws, Anna Gavin, Daniela Tataru, Lizz Paley, David Wallace, and Guruprasad Aithal, BASL president. NCRAS advisor: Sean McPhail. Cancer data sources: Data for this study are based on patient-level information collected by the NHS, as part of the care and support of cancer patients. The data is collated, maintained, and quality assured by the: National Cancer Registration and Analysis Service, which is part of Public Health England (PHE); Welsh Cancer Intelligence and Surveillance Unit, Health Intelligence Division, Public Health Wales: Scottish Cancer Registry, Information Services Division; and NI Cancer Registry, funded by The Public Health Agency for Northern Ireland.

Funding Information:
All of the authors completed the ICMJE uniform disclosure form; GA, AM, DT, DH, DW, TGB, and RJD have nothing to disclose. During the conduct of the study, AB reports grants from BTG International Ltd. Outside of the submitted work TJSC reports grants from Sirtex, Bristol-Myers-Squibb, and Bayer and personal fees from Eisai pharmaceuticals, Bayer, AstraZeneca, and Roche. IAR reports personal fees from Roche and Abbvie, outside the submitted work.

Funding Information:
This work was supported by the British Association for the Study of the Liver, which received an unrestricted and unconditional award from BTG International Ltd (grant number 52733 1 0). BTG did not have any input into the study design, data collection, analysis or interpretation of the data, writing of the manuscript, review of the manuscript, the decision to submit the manuscript, or the writing of this statement.

Publisher Copyright:
© 2021

Keywords

Hepatocellular carcinoma
Incidence
Intrahepatic cholangiocarcinoma
Mortality
Primary liver cancer
Survival
DIAGNOSIS
CHOLANGIOCARCINOMA
RATES
RISK
TRENDS

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.jhepr.2021.100232

Cite this

@article{86e2b8a53b4a441ea7e0e8b19405763f,

title = "Primary liver cancer in the UK: Incidence, incidence-based mortality, and survival by subtype, sex, and nation",

abstract = "Background & Aims: The incidence of primary liver cancer (PLC) is increasing in Western Europe. To understand trends over time and the current burden in the UK, a detailed analysis of the epidemiology of PLC and its subtypes was conducted.Methods: Data on PLCs diagnosed during 1997-2017 were obtained from population-based, nationwide registries in the UK. European age-standardised incidence (ASR) and incidence-based mortality rates (ASMR) per 100,000 person-years were calculated overall and by sex and UK-nation. Annual percentage change in rates was estimated using Joinpoint regression. One-, 2-, and 5-year age-standardised net survival was estimated.Results: A total of 82,024 PLCs were diagnosed. Both hepatocellular carcinoma (HCC) incidence and mortality rates trebled (ASR 1.8-5.5 per 100,000, ASMR 1.3-4.0). The rate of increase appeared to plateau around 2014/2015. Scottish men consistently had the highest HCC incidence rates. PLC survival increased, driven by a substantial increase in the proportion that are HCC (as prognosis is better than other PLCs) and in HCC survival (change in 1-year survival 24-47%). Intrahepatic cholangiocarcinoma was the most common PLC in women and 1-year survival improved from 22.6% to 30.5%.Conclusions: PLC incidence has been increasing rapidly but, as most risk factors are modifiable, it is largely a preventable cancer. This rate of increase has slowed in recent years, possibly attributable to effective treatment for hepatitis C. As other risk factors such as obesity and diabetes remain prevalent in the UK, it is unlikely the considerable burden of this disease will abate. While improvements in survival have been made, over half of patients are not alive after 1 year, therefore further progress in prevention, early detection, and treatment innovation are needed.Lay summary: Many more people are getting liver cancer, particularly the subtype hepatocellular carcinoma, than 20 years ago. Men in Scotland are most likely to get liver cancer and to die from it. Survival after liver cancer diagnosis is getting longer but still less than half are alive after 1 year. Crown Copyright (C) 2021 Published by Elsevier B.V. on behalf of European Association for the Study of the Liver (EASL).",

keywords = "Hepatocellular carcinoma, Incidence, Intrahepatic cholangiocarcinoma, Mortality, Primary liver cancer, Survival, DIAGNOSIS, CHOLANGIOCARCINOMA, RATES, RISK, TRENDS",

author = "{HCC-UK/BASL/NCRAS Partnership Steering Group} and Anya Burton and Daniela Tataru and Driver, {Robert J.} and Bird, {Thomas G.} and Dyfed Huws and David Wallace and Cross, {Timothy J.S.} and Rowe, {Ian A.} and Graeme Alexander and Aileen Marshall and Ian Rowe and Vinay Kumar and Tim Cross and Katherine Cullen and Rhys Pockett and Tom Bird and Huws, {Dyfed W.} and Anna Gavin and Elizabeth Paley and Guruprasad Aithal",

note = "Funding Information: HCC-UK BASL/NCRAS Partnership Steering Group: Anya Burton, Aileen Marshall, Graeme Alexander, Ian Rowe, Robert J. Driver, Vinay Kumar, Tim Cross, Katherine Cullen, Rhys Pockett, Tom Bird, Dyfed W. Huws, Anna Gavin, Daniela Tataru, Lizz Paley, David Wallace, and Guruprasad Aithal, BASL president. NCRAS advisor: Sean McPhail. Cancer data sources: Data for this study are based on patient-level information collected by the NHS, as part of the care and support of cancer patients. The data is collated, maintained, and quality assured by the: National Cancer Registration and Analysis Service, which is part of Public Health England (PHE); Welsh Cancer Intelligence and Surveillance Unit, Health Intelligence Division, Public Health Wales: Scottish Cancer Registry, Information Services Division; and NI Cancer Registry, funded by The Public Health Agency for Northern Ireland. Funding Information: All of the authors completed the ICMJE uniform disclosure form; GA, AM, DT, DH, DW, TGB, and RJD have nothing to disclose. During the conduct of the study, AB reports grants from BTG International Ltd. Outside of the submitted work TJSC reports grants from Sirtex, Bristol-Myers-Squibb, and Bayer and personal fees from Eisai pharmaceuticals, Bayer, AstraZeneca, and Roche. IAR reports personal fees from Roche and Abbvie, outside the submitted work. Funding Information: This work was supported by the British Association for the Study of the Liver, which received an unrestricted and unconditional award from BTG International Ltd (grant number 52733 1 0). BTG did not have any input into the study design, data collection, analysis or interpretation of the data, writing of the manuscript, review of the manuscript, the decision to submit the manuscript, or the writing of this statement. Publisher Copyright: {\textcopyright} 2021",

year = "2021",

month = apr,

doi = "10.1016/j.jhepr.2021.100232",

language = "English",

volume = "3",

journal = "JHEP Reports",

issn = "2589-5559",

publisher = "Elsevier B.V.",

number = "2",

}

TY - JOUR

T1 - Primary liver cancer in the UK

T2 - Incidence, incidence-based mortality, and survival by subtype, sex, and nation

AU - HCC-UK/BASL/NCRAS Partnership Steering Group

AU - Burton, Anya

AU - Tataru, Daniela

AU - Driver, Robert J.

AU - Bird, Thomas G.

AU - Huws, Dyfed

AU - Wallace, David

AU - Cross, Timothy J.S.

AU - Rowe, Ian A.

AU - Alexander, Graeme

AU - Marshall, Aileen

AU - Rowe, Ian

AU - Kumar, Vinay

AU - Cross, Tim

AU - Cullen, Katherine

AU - Pockett, Rhys

AU - Bird, Tom

AU - Huws, Dyfed W.

AU - Gavin, Anna

AU - Paley, Elizabeth

AU - Aithal, Guruprasad

N1 - Funding Information: HCC-UK BASL/NCRAS Partnership Steering Group: Anya Burton, Aileen Marshall, Graeme Alexander, Ian Rowe, Robert J. Driver, Vinay Kumar, Tim Cross, Katherine Cullen, Rhys Pockett, Tom Bird, Dyfed W. Huws, Anna Gavin, Daniela Tataru, Lizz Paley, David Wallace, and Guruprasad Aithal, BASL president. NCRAS advisor: Sean McPhail. Cancer data sources: Data for this study are based on patient-level information collected by the NHS, as part of the care and support of cancer patients. The data is collated, maintained, and quality assured by the: National Cancer Registration and Analysis Service, which is part of Public Health England (PHE); Welsh Cancer Intelligence and Surveillance Unit, Health Intelligence Division, Public Health Wales: Scottish Cancer Registry, Information Services Division; and NI Cancer Registry, funded by The Public Health Agency for Northern Ireland. Funding Information: All of the authors completed the ICMJE uniform disclosure form; GA, AM, DT, DH, DW, TGB, and RJD have nothing to disclose. During the conduct of the study, AB reports grants from BTG International Ltd. Outside of the submitted work TJSC reports grants from Sirtex, Bristol-Myers-Squibb, and Bayer and personal fees from Eisai pharmaceuticals, Bayer, AstraZeneca, and Roche. IAR reports personal fees from Roche and Abbvie, outside the submitted work. Funding Information: This work was supported by the British Association for the Study of the Liver, which received an unrestricted and unconditional award from BTG International Ltd (grant number 52733 1 0). BTG did not have any input into the study design, data collection, analysis or interpretation of the data, writing of the manuscript, review of the manuscript, the decision to submit the manuscript, or the writing of this statement. Publisher Copyright: © 2021

PY - 2021/4

Y1 - 2021/4

N2 - Background & Aims: The incidence of primary liver cancer (PLC) is increasing in Western Europe. To understand trends over time and the current burden in the UK, a detailed analysis of the epidemiology of PLC and its subtypes was conducted.Methods: Data on PLCs diagnosed during 1997-2017 were obtained from population-based, nationwide registries in the UK. European age-standardised incidence (ASR) and incidence-based mortality rates (ASMR) per 100,000 person-years were calculated overall and by sex and UK-nation. Annual percentage change in rates was estimated using Joinpoint regression. One-, 2-, and 5-year age-standardised net survival was estimated.Results: A total of 82,024 PLCs were diagnosed. Both hepatocellular carcinoma (HCC) incidence and mortality rates trebled (ASR 1.8-5.5 per 100,000, ASMR 1.3-4.0). The rate of increase appeared to plateau around 2014/2015. Scottish men consistently had the highest HCC incidence rates. PLC survival increased, driven by a substantial increase in the proportion that are HCC (as prognosis is better than other PLCs) and in HCC survival (change in 1-year survival 24-47%). Intrahepatic cholangiocarcinoma was the most common PLC in women and 1-year survival improved from 22.6% to 30.5%.Conclusions: PLC incidence has been increasing rapidly but, as most risk factors are modifiable, it is largely a preventable cancer. This rate of increase has slowed in recent years, possibly attributable to effective treatment for hepatitis C. As other risk factors such as obesity and diabetes remain prevalent in the UK, it is unlikely the considerable burden of this disease will abate. While improvements in survival have been made, over half of patients are not alive after 1 year, therefore further progress in prevention, early detection, and treatment innovation are needed.Lay summary: Many more people are getting liver cancer, particularly the subtype hepatocellular carcinoma, than 20 years ago. Men in Scotland are most likely to get liver cancer and to die from it. Survival after liver cancer diagnosis is getting longer but still less than half are alive after 1 year. Crown Copyright (C) 2021 Published by Elsevier B.V. on behalf of European Association for the Study of the Liver (EASL).

AB - Background & Aims: The incidence of primary liver cancer (PLC) is increasing in Western Europe. To understand trends over time and the current burden in the UK, a detailed analysis of the epidemiology of PLC and its subtypes was conducted.Methods: Data on PLCs diagnosed during 1997-2017 were obtained from population-based, nationwide registries in the UK. European age-standardised incidence (ASR) and incidence-based mortality rates (ASMR) per 100,000 person-years were calculated overall and by sex and UK-nation. Annual percentage change in rates was estimated using Joinpoint regression. One-, 2-, and 5-year age-standardised net survival was estimated.Results: A total of 82,024 PLCs were diagnosed. Both hepatocellular carcinoma (HCC) incidence and mortality rates trebled (ASR 1.8-5.5 per 100,000, ASMR 1.3-4.0). The rate of increase appeared to plateau around 2014/2015. Scottish men consistently had the highest HCC incidence rates. PLC survival increased, driven by a substantial increase in the proportion that are HCC (as prognosis is better than other PLCs) and in HCC survival (change in 1-year survival 24-47%). Intrahepatic cholangiocarcinoma was the most common PLC in women and 1-year survival improved from 22.6% to 30.5%.Conclusions: PLC incidence has been increasing rapidly but, as most risk factors are modifiable, it is largely a preventable cancer. This rate of increase has slowed in recent years, possibly attributable to effective treatment for hepatitis C. As other risk factors such as obesity and diabetes remain prevalent in the UK, it is unlikely the considerable burden of this disease will abate. While improvements in survival have been made, over half of patients are not alive after 1 year, therefore further progress in prevention, early detection, and treatment innovation are needed.Lay summary: Many more people are getting liver cancer, particularly the subtype hepatocellular carcinoma, than 20 years ago. Men in Scotland are most likely to get liver cancer and to die from it. Survival after liver cancer diagnosis is getting longer but still less than half are alive after 1 year. Crown Copyright (C) 2021 Published by Elsevier B.V. on behalf of European Association for the Study of the Liver (EASL).

KW - Hepatocellular carcinoma

KW - Incidence

KW - Intrahepatic cholangiocarcinoma

KW - Mortality

KW - Primary liver cancer

KW - Survival

KW - DIAGNOSIS

KW - CHOLANGIOCARCINOMA

KW - RATES

KW - RISK

KW - TRENDS

UR - http://www.scopus.com/inward/record.url?scp=85102292866&partnerID=8YFLogxK

U2 - 10.1016/j.jhepr.2021.100232

DO - 10.1016/j.jhepr.2021.100232

M3 - Article

AN - SCOPUS:85102292866

SN - 2589-5559

VL - 3

JO - JHEP Reports

JF - JHEP Reports

IS - 2

M1 - 100232

ER -

Primary liver cancer in the UK: Incidence, incidence-based mortality, and survival by subtype, sex, and nation

Abstract

Bibliographical note

Keywords

UN SDGs

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