Advanced Hepatocellular Carcinoma Tumor Stage at Diagnosis in the 1945‐1965 Birth Cohort Reflects Poor Use of Hepatocellular Carcinoma Screening

摘要

Individuals from the 1945‐1965 birth cohort account for the majority of hepatocellular carcinoma (HCC) cases in the United States. Understanding trends in HCC among this birth cohort is vital given the increasing burden of chronic liver disease among this group. We retrospectively evaluated trends and disparities in HCC tumor stage at the time of diagnosis among the 1945‐1965 birth cohort in the United States using the Surveillance, Epidemiology, and End Results (SEER) cancer registry. Tumor stage at the time of HCC diagnosis was assessed using Milan criteria and SEER HCC staging systems. Among 38,045 patients with HCC within the 1945‐1965 birth cohort (81.6% male, 50.1% non‐Hispanic white, 16.2% African American, 12.6% Asian, 19.8% Hispanic), 66.2% had Medicare or commercial insurance, 27.2% had Medicaid, and 6.6% were uninsured. During the period 2004‐2006 to 2013‐2014, the number of patients with HCC from the 1945‐1965 birth cohort increased by 58.7% (5.9% increase per year). While the proportion of patients with HCC within the Milan criteria increased with time (36.4% in 2003‐2006 to 46.3% in 2013‐2014; P.