Increase in Hepatocellular Carcinoma Deaths with Chronic Hepatitis Infection in England between 1996 and 2014
Author(s): ,
Annastella Costella
Affiliations:
Public Health England
,
Koye Balogun
Affiliations:
Public Health England
,
Nick Andrews
Affiliations:
Public Health England
,
Sema Mandal
Affiliations:
Public Health England
,
Mary Ramsay
Affiliations:
Public Health England
Helen Harris
Affiliations:
Public Health England
PHE ePoster Library. Costella A. 03/20/18; 205926; 12597
Ms. Annastella Costella
Ms. Annastella Costella
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Abstract
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Abstract According to the World Health Organization, in 2015 approximately 71 million and 257 million people worldwide were chronically infected with hepatitis C virus (HCV) and hepatitis B virus (HBV) respectively. Liver cancer is the second most common cause of cancer death globally, accounting for 788,000 deaths. Mortality data were reviewed to identify individuals with hepatocellular carcinoma (HCC), HBV or HCV mentioned on their death certificates. Data were analysed to describe trends in HCC deaths, examine the country of birth and age at death from HCC in those with and without a mention of HBV or HCV on their death certificate. Between 1996 and 2014, HCC deaths in England increased from 611 to 1,799. There was a significant increase in the proportion of HCV-related HCC deaths (4.3% in 1996 and 9.8% in 2014 p for trend <0.001) of which an increasing proportion were UK born (P<0.001). There was a significant decrease in the proportion of HBV-related HCC deaths (5.2% in 1996 and 2.5% in 2014 p for trend 0.003) and a slight increase in trend seen in the proportion of non-UK born individuals (P=0.025). The mean age at death was lower for individuals with HBV-related HCC (56 years) and HCV-related HCC (62 years) compared to those with non-HBV/HCV-related HCC (71 years). Improvements in HCC diagnosis and HBV/HCV detection alongside rising obesity levels and alcohol consumption may be responsible for increases in HCC mortality. The increasing proportion of HCV-related HCC deaths may be due to injecting drug use that began several decades earlier. The decreasing proportion of HBV-related HCC deaths may be the result of improvements in HBV control. Premature mortality associated with HBV and HCV can be avoided with targeted prevention activity, including HBV immunisation and harm minimisation measures in risk groups; improved awareness; early diagnosis and increased access to treatment.
Abstract According to the World Health Organization, in 2015 approximately 71 million and 257 million people worldwide were chronically infected with hepatitis C virus (HCV) and hepatitis B virus (HBV) respectively. Liver cancer is the second most common cause of cancer death globally, accounting for 788,000 deaths. Mortality data were reviewed to identify individuals with hepatocellular carcinoma (HCC), HBV or HCV mentioned on their death certificates. Data were analysed to describe trends in HCC deaths, examine the country of birth and age at death from HCC in those with and without a mention of HBV or HCV on their death certificate. Between 1996 and 2014, HCC deaths in England increased from 611 to 1,799. There was a significant increase in the proportion of HCV-related HCC deaths (4.3% in 1996 and 9.8% in 2014 p for trend <0.001) of which an increasing proportion were UK born (P<0.001). There was a significant decrease in the proportion of HBV-related HCC deaths (5.2% in 1996 and 2.5% in 2014 p for trend 0.003) and a slight increase in trend seen in the proportion of non-UK born individuals (P=0.025). The mean age at death was lower for individuals with HBV-related HCC (56 years) and HCV-related HCC (62 years) compared to those with non-HBV/HCV-related HCC (71 years). Improvements in HCC diagnosis and HBV/HCV detection alongside rising obesity levels and alcohol consumption may be responsible for increases in HCC mortality. The increasing proportion of HCV-related HCC deaths may be due to injecting drug use that began several decades earlier. The decreasing proportion of HBV-related HCC deaths may be the result of improvements in HBV control. Premature mortality associated with HBV and HCV can be avoided with targeted prevention activity, including HBV immunisation and harm minimisation measures in risk groups; improved awareness; early diagnosis and increased access to treatment.
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