Clin Mol Hepatol.  2023 Jan;29(1):120-134. 10.3350/cmh.2021.0395.

Hepatocellular carcinoma incidence is decreasing in Korea but increasing in the very elderly

Affiliations
  • 1Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea
  • 2Big Data Steering Department, National Health Insurance Service, Wonju, Korea
  • 3Department of Health Administration, Graduate School, Yonsei University, Wonju, Korea
  • 4Big Data Center, Department of Statistics, Yonsei University Wonju College of Medicine, Wonju, Korea
  • 5Biostatistical Consulting and Research Lab, Medical Research Collaborating Center, Hanyang University, Seoul, Korea
  • 6Department of Medical and Digital Engineering, Hanyang University College of Engineering, Seoul, Korea
  • 7Department of Internal Medicine, School of Medicine, Hanyang University, Seoul, Korea
  • 8Department of Gastroenterology, Ajou University School of Medicine, Suwon, Korea
  • 9Department of Internal Medicine, Eulji University College of Medicine, Seoul, Korea
  • 10Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea

Abstract

Background/Aims
A comprehensive analysis of trends in the incidence of hepatocellular carcinoma (HCC) is important for planning public health initiatives. We aimed to analyze the trends in HCC incidence in South Korea over 10 years and to predict the incidence for the year 2028.
Methods
Data from patients with newly diagnosed HCC between 2008 and 2018 were obtained from Korean National Health Insurance Service database. Age-standardized incidence rates (ASRs) were calculated to compare HCC incidence. A poisson regression model was used to predict the future incidence of HCC.
Results
The average crude incidence rate (CR) was 22.4 per 100,000 person-years, and the average ASR was 17.6 per 100,000 person-years between 2008 and 2018. The CR (from 23.9 to 21.2 per 100,000 person-years) and ASR (from 21.9 to 14.3 per 100,000 person-years) of HCC incidence decreased during the past ten years in all age groups, except in the elderly. The ASR of patients aged ≥80 years increased significantly (from 70.0 to 160.2/100,000 person-years; average annual percent change, +9.00%; P<0.001). The estimated CR (17.9 per 100,000 person-years) and ASR (9.7 per 100,000 person-years) of HCC incidence in 2028 was declined, but the number of HCC patients aged ≥80 years in 2028 will be quadruple greater than the number of HCC patients in 2008 (from 521 to 2,055), comprising 21.3% of all HCC patients in 2028.
Conclusions
The ASRs of HCC in Korea have gradually declined over the past 10 years, but the number, CR, and ASR are increasing in patients aged ≥80 years.

Keyword

Age-standardized incidence rate; Hepatocellular carcinoma; Incidence; Korea; Prediction
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