Years of life that could be saved from prevention of hepatocellular carcinoma

Aliment Pharmacol Ther. 2016 Apr;43(7):814-24. doi: 10.1111/apt.13554. Epub 2016 Feb 11.

Abstract

Background: Hepatocellular carcinoma (HCC) causes premature death and loss of life expectancy worldwide. Its primary and secondary prevention can result in a significant number of years of life saved.

Aim: To assess how many years of life are lost after HCC diagnosis.

Methods: Data from 5346 patients with first HCC diagnosis were used to estimate lifespan and number of years of life lost after tumour onset, using a semi-parametric extrapolation having as reference an age-, sex- and year-of-onset-matched population derived from national life tables.

Results: Between 1986 and 2014, HCC lead to an average of 11.5 years-of-life lost for each patient. The youngest age-quartile group (18-61 years) had the highest number of years-of-life lost, representing approximately 41% of the overall benefit obtainable from prevention. Advancements in HCC management have progressively reduced the number of years-of-life lost from 12.6 years in 1986-1999, to 10.7 in 2000-2006 and 7.4 years in 2007-2014. Currently, an HCC diagnosis when a single tumour <2 cm results in 3.7 years-of-life lost while the diagnosis when a single tumour ≥ 2 cm or 2/3 nodules still within the Milan criteria, results in 5.0 years-of-life lost, representing the loss of only approximately 5.5% and 7.2%, respectively, of the entire lifespan from birth.

Conclusions: Hepatocellular carcinoma occurrence results in the loss of a considerable number of years-of-life, especially for younger patients. In recent years, the increased possibility of effectively treating this tumour has improved life expectancy, thus reducing years-of-life lost.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Hepatocellular / epidemiology*
  • Carcinoma, Hepatocellular / prevention & control*
  • Databases, Factual / trends
  • Disease Management
  • Female
  • Humans
  • Italy / epidemiology
  • Life Expectancy / trends*
  • Liver Neoplasms / epidemiology*
  • Liver Neoplasms / prevention & control*
  • Male
  • Middle Aged
  • Primary Prevention / trends
  • Prospective Studies
  • Registries
  • Secondary Prevention / trends
  • Young Adult