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Hepatocellular carcinoma in Australia's Northern Territory: high incidence and poor outcome

Parker, Christopher, Tong, Steven Y. C., Dempsey, Karen, Condon, John R., Sharma, Suresh K., Chen, John, Sievert, William and Davis, Joshua S. (2014). Hepatocellular carcinoma in Australia's Northern Territory: high incidence and poor outcome. Medical Journal of Australia,201(8):470-474.

Document type: Journal Article
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IRMA ID 84473293xPUB103
Title Hepatocellular carcinoma in Australia's Northern Territory: high incidence and poor outcome
Author Parker, Christopher
Tong, Steven Y. C.
Dempsey, Karen
Condon, John R.
Sharma, Suresh K.
Chen, John
Sievert, William
Davis, Joshua S.
Journal Name Medical Journal of Australia
Publication Date 2014
Volume Number 201
Issue Number 8
ISSN 0025-729X   (check CDU catalogue open catalogue search in new window)
Start Page 470
End Page 474
Total Pages 5
Place of Publication Australia
Publisher Australasian Medical Publishing Company Pty. Ltd.
HERDC Category C1 - Journal Article (DIISR)
Abstract Objective: To describe the epidemiology, clinical features, management and outcomes of hepatocellular carcinoma (HCC) in the Northern Territory over the past decade.

Design, setting and patients: An NT-wide epidemiology study covering the period 1991–2010 and a clinical cohort study including patients diagnosed during 2000–2011. HCC diagnoses were provided by the NT Cancer Registry and cross-checked against clinical records.

Main outcome measures:
Age-adjusted incidence of HCC; management; clinical features; and median and 1-year survival.

Results: There were 145 incident cases of HCC in the NT during 1991–2010, giving an age-adjusted annual incidence of 22.7/100 000 (95% CI, 17.2–26.8) for Indigenous Australians and 4.0/100 000 (95% CI, 2.1–5.8) for non-Indigenous Australians — an incidence rate ratio of 5.9 (95% CI, 4.7–7.4). There was no significant change in annual age-adjusted incidence over this period. The most common causative factors were hepatitis B virus in Indigenous people and hepatitis C virus in non-Indigenous people. Most people were diagnosed late, only 13/80 were diagnosed by screening, and outcomes were poor, with 28/80 overall surviving to 1 year. Outcomes were better among those managed through a centralised multidisciplinary service than among those who were not (adjusted hazard ratio for death at 1 year, 0.35 [95% CI, 0.16–0.81]).

Conclusion: HCC incidence remains high in the Indigenous people of the NT. More resources are needed for HCC surveillance and management programs in this population.

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