Hepatocellular carcinoma is leading in cancer-related disease burden among hospitalized baby boomers

摘要

Introduction and ObjectivesThree fourths of chronic hepatitis C virus (HCV) infected adult patients in the United States (US) are born between 1945 and 1965, also known as baby boomers (BB). Prevalence of hepatocellular carcinoma (HCC) is raising in BB due to their advancing age and prolonged HCV infection. We evaluated inpatient hospitalization and mortality in BB associated with HCC.Materials and methodsIt is a retrospective cohort study utilizing the Healthcare Utilization Project-National Inpatient Sample (HCUP-NIS) database. From 2003 to 2012, top five primary cancer related hospitalization and mortality among BB were studied.ResultsAmong 48,733 hospitalizations related to HCC in HCUP-NIS database from 2003 to 2012, BB accounted for 49.6 (24,210) whereas non-BB 50.4 (24,523). Within BB cohort, the top five cancers with the highest proportion of hospitalizations were HCC (46), prostate (43), kidney (41), pancreas (33), and bladder (21). From 2003 to 2012, the proportion of HCC related hospitalizations represented by BB almost doubled (33.5 to 57.8) whereas there was one-third reduction (66.4 to 42.1) among non-BB. Similarly, HCC-related inpatient mortality in BB decreased by 28 (6.1 to 2.7 per 100,000 hospitalization) but it remained unchanged in non-BB (11.1 to 10.6). HCC accounted for 2nd highest mortality (4960 total deaths) among hospitalized BB behind pancreatic cancer. HCC related to HCV was disproportionately higher in BB compared to non-BB (50.6 vs. 19; P < 0.001).ConclusionHCC ranks number one among the top five cancers with highest proportion of inpatient burden. Future studies should focus on understanding the underlying reasons for this ominous trend.