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Published on: September 30, 2021
The changing characteristics of hepatocellular cancer in Hawaii over time
Linda L Wong1, Makoto Ogihara2, Junfang Ji3
1Department of Surgery, John A. Burns School of Medicine, University of Hawaii, 550 South Beretania Street, Suite 403, Honolulu, Hawaii 96813, USA; Transplant Center, Queens Medical Center, Honolulu, HI, USA; Cancer Center, University of Hawaii, Honolulu, HI, USA.
Background:
The incidence of hepatocellular cancer (HCC) is increasing, and we sought to characterize the differences and trends in HCC over 2 decades in Hawaii.
Methods:
This retrospective study of 821 HCC cases analyzed risk factors, diabetes, alpha-fetoprotein (AFP), tumor characteristics, and treatment, comparing 5-year eras (1993 to 2012).
Results:
With succeeding eras, there were fewer Asians, immigrants, and hepatitis B-related HCC. Hepatitis C, diabetes, hyperlipidemia, and body mass index have increased. Over time, more patients had normal AFP, and normal AFP was seen more often in nonviral HCC (49.6% vs 33.2%, P = .007). Over time, the proportion of patients who underwent resection or transplant was stable, but fewer patients underwent no therapy.
Conclusions:
Characteristics of HCC are changing, and diagnosis may be more difficult as metabolic factors are becoming more important than viral factors. AFP seems to be a less important biomarker, and clearly, better diagnostic tools will be necessary to identify HCC in the future.
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