Clinical-liver, pancreas, and biliary tractHepatitis C infection and the increasing incidence of hepatocellular carcinoma: A population-based study
Section snippets
Data source
Data used for this study were obtained from the SEER-Medicare database, which is the linkage of SEER registry information with Medicare claims data. The SEER program is an ongoing contract-supported program of the National Cancer Institute to collect population-based cancer incidence and survival data. Since 1992, the SEER program has collected data on incident cancer cases from 11 population-based cancer registries in 5 states (Connecticut, Hawaii, Iowa, New Mexico, Utah) and 6 metropolitan
Results
We initially identified 4015 patients age 65 years and older in the SEER-Medicare database with diagnostically confirmed HCC between 1993 and 1999. Of these cases, 2584 patients with HCC satisfied our criteria for inclusion in the study cohort. The 1431 patients were excluded for the following reasons: enrollment in a Medicare HMO plan during the 2 years before or after the date of HCC diagnosis (n = 960); enrollment in Medicare part A and part B for less than 2 years before the index date (n =
Discussion
Our study was a population-based study to examine the underlying risk factors among patients with HCC in the United States between 1993 and 1999. Among Medicare-enrolled patients with HCC, significant increases in HCV- and HBV-related HCC occurred over the past decade, whereas HCC associated with alcohol-induced liver disease, nonspecific cirrhosis, and nonspecific hepatitis has remained unchanged. HCV-related HCC doubled from 11% to 21% of all HCCs, whereas HBV-related HCC increased from 6% to
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