Objective Hepatocellular carcinoma (HCC) is increasingly incident in England, while survival remains poor with regional disparities. We aimed to explore the differences in HCC treatment across different geographical regions and to examine the impact on cancer survival.
Methods Incident HCC cases and treatment were identified from the English Hospital Episode Statistics (2016–2017) and then a subset by National Health Service (NHS) regions. Treatment was grouped into curative, palliative and untreated. Median survival was estimated to date of death in the national statistics.
Results The median observed survival was 8.6 months (95% CI 7.5 to 9.9) across all 2160 HCC cases, 52.1 months (CI 50.5, not reached) in 449 (20.8%) treated with curative intent, 21.0 months (CI 18.5 to 24.5) after other cancer-specific treatment in 449 (20.8%), and 2.3 months (CI 2.1 to 2.6) in 1262 (58.4%) untreated. Across NHS regions, <50% of cases received treatment (30.4%–49.6%), while between 14.2% and 27.7% had curative treatment. The 3-year survival was similar (23.5%–29.7%), except in the London region (40.0%).
Conclusion Majority of HCC cases in England are untreated and survival remains low, with variation in outcomes in regions with similar incident rates. A deeper exploration of regional treatments and screening practice is required to improve early detection and survival.
- hepatocellular carcinoma
Data availability statement
Data are available upon reasonable request.
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Contributors AN, TJSC and DP originated the concept. SB and MO'C performed the data analysis and initial drafting of the manuscript. All authors contributed to iterative drafting of the manuscript. AN is the guarantor of the manuscript.
Funding The study was funded by Bristol Myers Squibb.
Competing interests KN, KP and AN are employees of Bristol Myers Squibb.
Provenance and peer review Not commissioned; externally peer reviewed.
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