Regional variations in hepatocellular carcinoma incidence, routes to diagnosis, treatment and survival in England


    Research output: Contribution to journalArticlepeer-review

    13 Citations (Scopus)


    Background: Hepatocellular carcinoma (HCC) incidence, management and survival across England were examined to determine if geographical inequalities exist. Method: 15,468 HCC cases diagnosed 2010–2016 were included. Age-standardised incidence rates, net survival and proportions receiving potentially curative treatment and presenting through each route to diagnosis adjusted for age at diagnosis, sex and area-based deprivation quintile, were calculated overall and by Cancer Alliance. Results: HCC incidence rates increased in men from 6.2 per 100,000 in 2010 to 8.8 in 2016, and in women from 1.5 to 2.2. The highest incidence rates, found in parts of the North of England and London, were nearly double the lowest. The adjusted proportion presenting as an emergency ranged 27–41% across Cancer Alliances. Odds increased with increasing deprivation quintile and age. Only one in five patients received potentially curative treatment (range 15–28%) and odds decreased with increasing deprivation and age. One-year survival in 2013–2016 ranged 38–53%. Conclusion: This population-based, nationwide analysis demonstrates clear differences in HCC incidence, management and survival across England. It highlights socioeconomic-associated variation and the need for improvement in early diagnosis and curative treatment of HCC. This research should assist policymakers, service providers and clinicians to identify regions where additional training, services and resources would be best directed.

    Original languageEnglish
    Pages (from-to)804-814
    Number of pages11
    JournalBritish Journal of Cancer
    Issue number5
    Early online date26 Nov 2021
    Publication statusE-pub ahead of print - 26 Nov 2021

    Bibliographical note

    Funding Information:
    This work was supported by the British Association for the Study of the Liver who received an unrestricted and unconditional award from BTG International Ltd. VKB was funded by educational grants from Bayer, Sirtex and Bristol-Myers-Squibb (BMS) during the conduct of the study. Neither BTG, Bayer, Sirtex nor BMS, had 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, The Author(s).


    • CANCER
    • IMPACT


    Dive into the research topics of 'Regional variations in hepatocellular carcinoma incidence, routes to diagnosis, treatment and survival in England'. Together they form a unique fingerprint.

    Cite this