간암 국가암검진사업에 참여한 만성B형간염 환자에서 간암 발생률 조사

• Published in: Journal of liver cancer Vol. 17; no. 2; pp. 136 - 143
• Main Authors: 최인승, In Seung Choi, 오치혁, Chi Hyuck Oh, 박소영, So Young Park, 안성은, Sung Eun Ahn, 박성진, Seong Jin Park, 최현림, Hyun Rim Choi, 김병호, Byung-ho Kim, 심재준, Jae-jun Shim
• Format: Journal Article
• Language: Korean
• Published: 대한간암학회 15.09.2017
• Subjects: Chronic; Hepatitis B; Hepatocellular carcinoma; Mass screening; 의학일반
• ISSN: 2288-8128; 2383-5001
• DOI: 10.17998/jlc.17.2.136

Background/Aims: To optimize efficacy of National Liver Cancer Screening Program (NLCSP) for subjects with chronic hepatitis B (CHB), it is needed to know the incidence of liver cancer and its predisposing factors in the program. Methods: From January 2010 to December 2014, all the hepatitis B surface antigen (HBsAg) positive participants who received at least two or more abdominal ultrasonography under NLCSP were retrospectively enrolled in a single tertiary hospital. Annual incidence of primary liver cancer was calculated and related clinical factors were investigated. Results: During 5 years, 541 subjects were enrolled. Mean age was 53 years old and 292 subjects (54%) were receiving antiviral agents. Liver cirrhosis (LC) was diagnosed in 212 (39.2%). Mean follow-up time was 2.36 years and 15 hepatocellular carcinoma and 1 intrahepatic cholangiocarcinoma were diagnosed. Annual incidence of primary liver cancer was 9.8 per 1,000 patient year. Cumulative incidence at 1, 3, and 5 year was 0.6%, 2.6%, and 6.4%, respectively. In multivariate analyses, LC (hazard ratio [HR] 8.74, 95% confidence interval [CI] 1.97-38.71, P=0.024), age (HR 1.08, 95% CI 1.01-1.15, P=0.024) were significantly associated with cancer development. Conclusions: Despite of high rate of oral antiviral therapy, incidence of primary liver cancer is not low in CHB patients in Korea. Old age and presence of LC are independently associated with higher risk of cancer development during surveillance. This study could be used as baseline data for quality control of NLCSP. (J Liver Cancer 2017;17:136-143)