Abstract 195P
Background
The landscape of HCC etiologies is shifting from viral to non-viral causes due to successful interventions against hepatitis B and C with a concurrent rise of metabolic risk factors. Contemporary analyses are imperative to update our understanding of HCC causes and improve prevention strategies. This study aims to describe the occurrence of risk factors in a large, German HCC patient population.
Methods
The cohort comprises incident patients with documented HCC (ICD C22.0) between 2016-2020 from claims data (BARMER). Inclusion criteria: ≥18 years (y), BARMER insured during the entire observation period. Exclusion criteria: prior cancer diagnosis within 5y. Patient characteristics and risk factors (according to ICD) within 10y before HCC diagnosis are determined using descriptive statistics. Based on a co-occurrence matrix, a network analysis was performed to investigate interrelations among HCC risk factors.
Results
A total of 2778 incident HCC patients were identified. 69% were male with a mean age of 71.9y (standard deviation [SD] ±9.7). Age distribution was 11% <60y, 29% 60-69y, and 60% ≥70y. Age-stratified analysis revealed that at least three risk factors were documented in 58% of patients aged <60y. In the age groups of 60-69y and ≥70y, the proportion was 67% and 55%, respectively. Most frequently documented risk factors were diabetes mellitus (76%), obesity (56%), liver fibrosis/cirrhosis (43.8%), and alcohol abuse (36%). Hepatitis B and C were documented in 4% and 11% of patients, respectively. The proportion of patients with lifestyle and metabolic risk factors was 1.11-1.66-fold higher in men than women. The network analysis identified diabetes mellitus as the most central risk factor, co-occurring with obesity, liver fibrosis/cirrhosis, and alcohol abuse.
Conclusions
In this large, contemporary German cohort, metabolic diseases have become the leading risk factors for HCC. Non-viral HCC is a multifactorial disease with frequent co-occurrence of obesity, diabetes, and alcohol abuse. Our results emphasize that controlling metabolic risk factors and surveilling at-risk populations are of crucial importance for mitigating the increasing incidence and improving the survival of HCC patients.
Legal entity responsible for the study
The authors.
Funding
Roche.
Disclosure
K. Berger-Thürmel: Financial Interests, Institutional, Research Grant: Roche. W. Hofmann: Financial Interests, Personal, Advisory Role: Ipsen, Falk, Novo Nordisc, Norgine, AbbVie, Gilead, Roche; Non-Financial Interests, Personal, Training: AbbVie, Gilead; Financial Interests, Personal, Invited Speaker: AbbVie, Gilead, Falk, Advanz Pharma. E.N. De Toni: Financial Interests, Personal and Institutional, Advisory Role: AstraZeneca, Bayer, BMS, Eisai, Eli Lilly & Co, Pfizer, Ipsen, Roche; Non-Financial Interests, Personal and Institutional, Training: Arqule, AstraZeneca, BMS, Bayer, Celsion, Roche; Financial Interests, Personal and Institutional, Invited Speaker: BMS, Falk; Financial Interests, Institutional, Research Grant: Arqule, AstraZeneca, BMS, Bayer, Eli Lilly & Co, Roche; Financial Interests, Personal, Full or part-time Employment: Boehringer-Ingelheim. N. Ben Khaled: Non-Financial Interests, Personal and Institutional, Training: Eisai; Financial Interests, Personal and Institutional, Invited Speaker: Falk, AstraZeneca. All other authors have declared no conflicts of interest.