Background: Identifying the projected incidence of hepatobiliary cancers and recognizing patient cohorts at increased risk can help develop targeted interventions and resource allocation. The expected incidence of subtypes of hepatobiliary cancers in different age groups, races, and genders remains unknown. Methods: Historical epidemiological data from the Surveillance, Epidemiology, and End Results (SEER) database was used to project future incidence of hepatobiliary malignancies in the United States and identify trends by age, race, and gender. Patients ≥18 years of age diagnosed with a hepatobiliary malignancy between 2001 and 2017 were included. US Census Bureau 2017 National Population projects provided the projected population from 2017 to 2029. Age–Period–Cohort forecasting model was used to estimate future births cohort-specific incidence. All analyses were completed using R Statistical Software. Results: We included 110381 historical patients diagnosed with a hepatobiliary malignancy between 2001 and 2017 with the following subtypes: hepatocellular cancer (HCC) (68%), intrahepatic cholangiocarcinoma (iCCA) (11.5%), gallbladder cancer (GC) (8%), extrahepatic cholangiocarcinoma (eCCA) (7.6%), and ampullary cancer (AC) (4%). Our models predict the incidence of HCC to double (2001 to 2029) from 4.5 to 9.03 per 100,000, with the most significant increase anticipated in patients 70–79 years of age. In contrast, incidence is expected to continue to decline among the Asian population. Incidence of iCCA is projected to increase, especially in the white population, with rates in 2029 double those in 2001 (2.13 vs. 0.88 per 100,000, respectively;p< 0.001). The incidence of GC among the black population is expected to increase. The incidence of eCCA is expected to significantly increase, especially among the Hispanic population, while that of AC will remain stable. Discussion: The overall incidence of hepatobiliary malignancies is expected to increase in the coming years, with certain groups at increased risk. These findings may help with resource allocation when considering screening, treatment, and research in the coming years.
背景：预测肝胆系统癌症的发病率并识别高风险患者群体，有助于制定针对性干预措施和优化资源配置。目前，不同年龄、种族和性别人群中肝胆系统癌症各亚型的预期发病率尚不明确。方法：本研究利用美国监测、流行病学和最终结果（SEER）数据库的历史流行病学数据，预测美国肝胆系统恶性肿瘤的未来发病率，并分析其在不同年龄、种族和性别中的变化趋势。研究纳入2001年至2017年间诊断为肝胆系统恶性肿瘤的18岁及以上患者。采用美国人口普查局2017年全国人口预测数据，估算2017年至2029年的预期人口。通过年龄-时期-队列预测模型，计算未来出生队列的特定发病率。所有分析均使用R统计软件完成。结果：共纳入2001年至2017年间诊断为肝胆系统恶性肿瘤的110381例历史患者，其亚型分布为：肝细胞癌（68%）、肝内胆管癌（11.5%）、胆囊癌（8%）、肝外胆管癌（7.6%）和壶腹癌（4%）。模型预测显示，肝细胞癌发病率将从2001年的每10万人4.5例增至2029年的9.03例（增长一倍），其中70-79岁人群增幅最为显著；而亚洲人群的发病率预计将持续下降。肝内胆管癌发病率预计上升，尤其在白种人群中，2029年发病率（每10万人2.13例）较2001年（每10万人0.88例）增长一倍（p<0.001）。黑种人群的胆囊癌发病率预计增加。肝外胆管癌发病率将显著上升，尤其在西班牙裔人群中，而壶腹癌发病率保持稳定。结论：未来几年肝胆系统恶性肿瘤总体发病率预计上升，特定人群风险显著增高。这些发现可为未来筛查、治疗及研究领域的资源配置提供参考依据。
肿瘤(癌症)患者之家