TY - JOUR
T1 - Hepatoblastoma incidence in Taiwan
T2 - A population-based study
AU - Hung, Giun Yi
AU - Lin, Li Yih
AU - Yu, Ting Yen
AU - Lee, Chih Ying
AU - Yen, Hsiu Ju
AU - Horng, Jiun Lin
N1 - Funding Information:
The data of patients with hepatoblastoma diagnosed from 1995 to 2012 were obtained from the TCR. Specifically, for children, the incidence data of HCC was also extracted to explore the trend of distribution in liver cancer subtypes during the study period. The TCR is organized and funded by the Health Promotion Administration, Ministry of Health and Welfare, Taiwan. A Cancer Registry Advisory Board was organized and responsible for standardizing the procedures, definitions of terminology, and coding of the reporting system for the registry. The TCR was launched in 1979, since the enactment of the Cancer Control Act in 2003, hospitals with a capacity of 50 or more beds that provide outpatient and hospitalized cancer care are mandated to submit cancer data to a central cancer registry office, and a trace-back procedure was also implemented, which substantially improved the completeness and case ascertainment of cancer registration. 12,13 In addition, Taiwan launched the single-payer National Health Insurance (NHI) program in 1995. 14 This compulsory universal social insurance system now covers 99.6% of Taiwan's population, and 93% of the hospitals and clinics are NHI-contracted, making it extremely convenient for all residents to get care. Beginning with 2002 incidence data, the International Classification of Diseases for Oncology, Third Edition (ICD-O-3) was used by TCR for coding instead of the ICD-O, Field Trial Edition. In the ICD-O-3, primary liver cancer is classified in “C22, cancer of the liver and intrahepatic bile ducts,” and the histology code for hepatoblastoma is 89703 (and 81703, 81713, 81723, 81733, 81743, and 81753 for HCC). The Census data by 5-year age group and sex were obtained from the Department of Statistics, Ministry of the Interior, Taiwan. Regarding the main measures of data quality defined by the International Agency for Research on Cancer (IARC), the proportion of microscopically verified cases (MV%) was 91.54% for all cancers combined in 2012. The percentage of cancer cases identified with death certification-only (DCO%) is another indicator of data validity, which decreased from 19.63% in 1995 to 0.72% in 2012. Specifically, for primary liver cancers, the mortality to incidence rate ratio was 1.05 in 1995 and decreased to 0.70 in 2012. MV% ranged from 38.9% in 1995 to 47.61% in 2012, and DCO% was 1.41% in 2012. 15 These measures reflect the high quality of the TCR data, with steady improvement over time, and its achievement of a standard comparable to other cancer registries in Western countries. 16,17 The data source of this study is the TCR public-access database ( http://www.hpa.gov.tw/BHPNet/Web/Stat/Statistics.aspx ) that consists of case numbers grouped according to the year of diagnosis, sex, and age (in 5-y age intervals). In addition, the MV% of hepatoblastoma and HCC were obtained via the Health and Welfare Data Science Center (HWDC), Taiwan. The HWDC guards the privacy of all enrollees, and provided the data to researchers who have obtained ethical approval. Before the release, all information that could potentially identify an individual person was encrypted. This observational study was approved by the Institutional Review Board of Taipei Veterans General Hospital, Taiwan (IRB-TPEVGH No.: 2016-10-001C). Because these data contain no identifiable personal information, the review board requirement for written informed consent was waived. 2.2
Funding Information:
The authors would like to express their sincerest gratitude to the Taiwan Cancer Registry, Health Promotion Administration, Ministry of Health and Welfare, Taiwan, for kindly providing incidence data and statistical consulting.
PY - 2018/6
Y1 - 2018/6
N2 - Background: The incidence of hepatoblastoma is not well known in Taiwan. The goal of this study was to investigate the incidence rates of hepatoblastoma by age and sex. Methods: The data of patients with hepatoblastoma diagnosed from 1995 to 2012 were obtained from the population-based Taiwan Cancer Registry. Incidence rates of hepatoblastoma according to sex and age were analyzed. This study employed the published methods of International Agency for Research on Cancer to calculate the age-standardized incidence rates (ASIRs), standard errors, 95% confidence intervals (CIs), and standardized incidence rate ratios (SIRRs). Results: In total, 211 patients were diagnosed with hepatoblastoma during the 18-year study period. The ASIR was 0.76 per million person-years. Hepatoblastoma was predominantly diagnosed in children (n = 184, 87.2%). By contrast, adolescents/adults (n = 10, 4.7%) and elderly people (n = 17, 8.1%) were rarely affected. The incidence peaked at ages 0–4 years with corresponding ASIR of 7.3 per million person-years. A significant male predilection was only found in children and elderly people, with male-to-female SIRRs of 1.23 and 1.89, respectively. During 1995–2012, the overall incidence of hepatoblastoma significantly increased only in children (annual percent change: 7.4%, 95% CI 3.9%–11.1%, p < 0.05) and specifically in boys (annual percent change: 6.5%, 95% CI 1.9%–11.2%, p < 0.05). Conclusion: Only 27 patients aged ≥ 15 years with hepatoblastoma were identified in this study, the existence of adult hepatoblastoma still requires novel molecular tools to elucidate. The association between the upward trend of hepatoblastoma incidence in boys and increased survival of prematurity in Taiwan warrants further investigations.
AB - Background: The incidence of hepatoblastoma is not well known in Taiwan. The goal of this study was to investigate the incidence rates of hepatoblastoma by age and sex. Methods: The data of patients with hepatoblastoma diagnosed from 1995 to 2012 were obtained from the population-based Taiwan Cancer Registry. Incidence rates of hepatoblastoma according to sex and age were analyzed. This study employed the published methods of International Agency for Research on Cancer to calculate the age-standardized incidence rates (ASIRs), standard errors, 95% confidence intervals (CIs), and standardized incidence rate ratios (SIRRs). Results: In total, 211 patients were diagnosed with hepatoblastoma during the 18-year study period. The ASIR was 0.76 per million person-years. Hepatoblastoma was predominantly diagnosed in children (n = 184, 87.2%). By contrast, adolescents/adults (n = 10, 4.7%) and elderly people (n = 17, 8.1%) were rarely affected. The incidence peaked at ages 0–4 years with corresponding ASIR of 7.3 per million person-years. A significant male predilection was only found in children and elderly people, with male-to-female SIRRs of 1.23 and 1.89, respectively. During 1995–2012, the overall incidence of hepatoblastoma significantly increased only in children (annual percent change: 7.4%, 95% CI 3.9%–11.1%, p < 0.05) and specifically in boys (annual percent change: 6.5%, 95% CI 1.9%–11.2%, p < 0.05). Conclusion: Only 27 patients aged ≥ 15 years with hepatoblastoma were identified in this study, the existence of adult hepatoblastoma still requires novel molecular tools to elucidate. The association between the upward trend of hepatoblastoma incidence in boys and increased survival of prematurity in Taiwan warrants further investigations.
KW - Hepatoblastoma
KW - Incidence
KW - Taiwan
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UR - http://www.mendeley.com/research/hepatoblastoma-incidence-taiwan-populationbased-study
U2 - 10.1016/j.jcma.2017.11.012
DO - 10.1016/j.jcma.2017.11.012
M3 - Article
AN - SCOPUS:85042021273
VL - 81
SP - 541
EP - 547
JO - Journal of the Chinese Medical Association
JF - Journal of the Chinese Medical Association
SN - 1726-4901
IS - 6
ER -