早期 COVID-19 大流行对美国肝细胞癌发病率和治疗效果的影响。

IF 3 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Clinical and Translational Gastroenterology Pub Date : 2024-07-01 DOI:10.14309/ctg.0000000000000723
Jeff Liang, Yi-Te Lee, Yee Hui Yeo, Michael Luu, Walid Ayoub, Alexander Kuo, Hirsh Trivedi, Aarshi Vipani, Srinivas Gaddam, Hyunseok Kim, Yun Wang, Nicole Rich, Kambiz Kosari, Nicholas Nissen, Neehar Parikh, Amit G Singal, Ju Dong Yang
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引用次数: 0

摘要

目标:在 COVID-19 大流行期间,肝细胞癌 (HCC) 的监测和治疗中断。我们旨在描述大流行对美国 HCC 发病率和死亡率、治疗和结果的影响:我们利用美国癌症统计和国家生命统计系统这两个全国性数据库对 2001-2020 年间的 HCC 发病率和死亡率进行了调查。采用连接点分析法评估了年龄调整后发病率(aIR)和死亡率(aMR)的变化趋势。根据流行前的数据预测了 2020 年的 aIR 和 aMR,并与实际值进行了比较,以评估诊断不足的程度。我们评估了2020年与2018-2019年之间HCC特征、治疗和总生存率(OS)的差异:2020年的HCC aIR与2019年相比明显下降(5.22 vs 6.03/100K PY),与2020年的预测aIR(5.94/100K PY)相比下降了12.2%。黑人(-14.87%)和西班牙裔(-14.51%)以及局部 HCC 患者(-15.12%)的诊断不足率最高。被分期为区域性或远处 HCC 的患者在 2020 年接受治疗的可能性也较低。然而,与2018-2019年相比,2020年的短期OS没有明显差异,HCC死亡率保持稳定(2020年与2019年相比,aMR:2.76 vs 2.73/100K PY):COVID-19大流行导致HCC诊断不足,尤其是早期疾病和少数种族,以及HCC定向治疗使用不足。要确定 COVID-19 大流行对 HCC 相关死亡率的影响,还需要更长时间的随访。
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Impact of the Early COVID-19 Pandemic on Incidence and Outcomes of Hepatocellular Carcinoma in the United States.

Introduction: Access to hepatocellular carcinoma (HCC) surveillance and treatments were disrupted during the coronavirus disease 2019 (COVID-19) pandemic. We aimed to characterize the impact of the pandemic on HCC incidence and mortality rates, treatment, and outcomes in the United States.

Methods: Two nationwide databases, the United States Cancer Statistics and the National Vital Statistics System, were used to investigate HCC incidence and mortality between 2001 and 2020. Trends in age-adjusted incidence rate (aIR) and adjusted mortality rate (aMR) were assessed using joinpoint analysis. The 2020 aIR and aMR were projected based on the prepandemic data and compared with actual values to assess the extent of underdiagnosis. We assessed differences in HCC characteristics, treatment, and overall survival between 2020 and 2018-2019.

Results: The aIR of HCC in 2020 was significantly reduced compared with 2019 (5.22 vs 6.03/100K person-years [PY]), representing a 12.2% decrease compared with the predicted aIR in 2020 (5.94/100K PY). The greatest extent of underdiagnosis was observed in Black (-14.87%) and Hispanic (-14.51%) individuals and those with localized HCC (-15.12%). Individuals staged as regional or distant HCC were also less likely to receive treatment in 2020. However, there was no significant difference in short-term overall survival in 2020 compared with 2018-2019, with HCC mortality rates remaining stable (aMR: 2.76 vs 2.73/100K PY in 2020 vs 2019).

Discussion: The COVID-19 pandemic resulted in underdiagnosis of HCC, particularly early stage disease and racial ethnic minorities, and underuse of HCC-directed treatment. Longer follow-up is needed to determine the impact of the COVID-19 pandemic on HCC-related mortality.

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来源期刊
Clinical and Translational Gastroenterology
Clinical and Translational Gastroenterology GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
7.00
自引率
0.00%
发文量
114
审稿时长
16 weeks
期刊介绍: Clinical and Translational Gastroenterology (CTG), published on behalf of the American College of Gastroenterology (ACG), is a peer-reviewed open access online journal dedicated to innovative clinical work in the field of gastroenterology and hepatology. CTG hopes to fulfill an unmet need for clinicians and scientists by welcoming novel cohort studies, early-phase clinical trials, qualitative and quantitative epidemiologic research, hypothesis-generating research, studies of novel mechanisms and methodologies including public health interventions, and integration of approaches across organs and disciplines. CTG also welcomes hypothesis-generating small studies, methods papers, and translational research with clear applications to human physiology or disease. Colon and small bowel Endoscopy and novel diagnostics Esophagus Functional GI disorders Immunology of the GI tract Microbiology of the GI tract Inflammatory bowel disease Pancreas and biliary tract Liver Pathology Pediatrics Preventative medicine Nutrition/obesity Stomach.
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