Original articlePancreas, biliary tract, and liverTemporal Trends of Nonalcoholic Fatty Liver Disease–Related Hepatocellular Carcinoma in the Veteran Affairs Population
Section snippets
Data Sources
Data were obtained from VA administrative data files and a review of patient electronic medical records (EMRs). Administrative data included the Medical SAS (MedSAS) Outpatient and Inpatient files, and the VA Vital Status File. The MedSAS files contain patient demographic data as well as diagnoses according to the International Classification of Diseases, 9th revision, Clinical Modification (ICD-9-CM) and procedures according to Common Procedural Terminology (CPT) codes. We determined the date
Results
The study cohort comprised 1500 patients diagnosed with HCC during fiscal years 2005 to 2010. Their mean age at the time of diagnosis was 63.7 years (SD, 9.5 y), and the vast majority were men (99.8%). The greatest proportions of patients were as follows: white non-Hispanic (59.8%), followed by blacks (26.1%), and Hispanics (11.9%). A liver mass biopsy was available in 786 (52.4%) cases to confirm the diagnosis of HCC, and the remainder were diagnosed according to radiologic features. HCV
Discussion
Our study shows that in the VA population between 7.5% and 12.0% of HCC cases were related to NAFLD and this proportion remained stable over the study period. We observed that NAFLD-related HCC patients have a distinct phenotype: older age, more likely to be white, and with less severe liver dysfunction at diagnosis compared with HCC from other causes. These patients received less medical attention as shown by lower rates of surveillance and treatment.
An earlier study on risk factors in HCC in
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Conflicts of interest The authors disclose no conflicts.
Funding Supported in part by the National Cancer Institute (R01 CA160738 to J.A.D.), the facilities and resources of the Houston Veterans Affairs Health Services Research and Development Center of Excellence (HFP90-020), the Michael E. DeBakey Veterans Affairs Medical Center, and the Dan Duncan Cancer Center (Houston, TX).