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Incidence of Primary Liver Cancer in Subjects with Chronic Hepatitis B in Korean National Liver Cancer Screening Program
Journal of Liver Cancer 2017³â 17±Ç 2È£ p.136 ~ p.143
ÃÖÀνÂ(Choi In-Seung) - °æÈñ´ëÇб³ ÀÇÇÐÀü¹®´ëÇпø ³»°úÇб³½Ç
¿ÀÄ¡Çõ(Oh Chi-Hyuk) - °æÈñ´ëÇб³ ÀÇÇÐÀü¹®´ëÇпø ³»°úÇб³½Ç
¹Ú¼Ò¿µ(Park So-Young) - °æÈñ´ëÇб³ ÀÇÇÐÀü¹®´ëÇпø ³»°úÇб³½Ç
¾È¼ºÀº(Ahn Sung-Eun) - °æÈñ´ëÇб³ ÀÇÇÐÀü¹®´ëÇпø ¿µ»óÀÇÇб³½Ç
¹Ú¼ºÁø(Park Seong-Jin) - °æÈñ´ëÇб³ ÀÇÇÐÀü¹®´ëÇпø ¿µ»óÀÇÇб³½Ç
ÃÖÇö¸²(Choi Hyun-Rim) - °æÈñ´ëÇб³ ÀÇÇÐÀü¹®´ëÇпø Á÷¾÷ȯ°æÀÇÇаú±³½Ç
±èº´È£(Kim Byung-Ho) - °æÈñ´ëÇб³ ÀÇÇÐÀü¹®´ëÇпø ³»°úÇб³½Ç
½ÉÀçÁØ(Shin Jae-Jun) - °æÈñ´ëÇб³ ÀÇÇÐÀü¹®´ëÇпø ³»°úÇб³½Ç
Abstract
Background/Aims: To optimize efficacy of National Liver Cancer Screening Program (NLCSP) for subjects with chronic hepatitis B (CHB), it is needed to know the incidence of liver cancer and its predisposing factors in the program.
Methods: From January 2010 to December 2014, all the hepatitis B surface antigen (HBsAg) positive participants who received at least two or more abdominal ultrasonography under NLCSP were retrospectively enrolled in a single tertiary hospital. Annual incidence of primary liver cancer was calculated and related clinical factors were investigated.
Results: During 5 years, 541 subjects were enrolled. Mean age was 53 years old and 292 subjects (54%) were receiving antiviral agents. Liver cirrhosis (LC) was diagnosed in 212 (39.2%). Mean follow-up time was 2.36 years and 15 hepatocellular carcinoma and 1 intrahepatic cholangiocarcinoma were diagnosed. Annual incidence of primary liver cancer was 9.8 per 1,000 patient year. Cumulative incidence at 1, 3, and 5 year was 0.6%, 2.6%, and 6.4%, respectively. In multivariate analyses, LC (hazard ratio [HR] 8.74, 95% confidence interval [CI] 1.97?38.71, P=0.024), age (HR 1.08, 95% CI 1.01?1.15, P=0.024) were significantly associated with cancer development.
Conclusions: Despite of high rate of oral antiviral therapy, incidence of primary liver cancer is not low in CHB patients in Korea. Old age and presence of LC are independently associated with higher risk of cancer development during surveillance. This study could be used as baseline data for quality control of NLCSP.
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Hepatocellular carcinoma, Hepatitis B, Chronic, Mass screening
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Old age and presence of LC are independently associated with higher risk of cancer development.