Prevalence of risk factors for hepatocellular carcinoma in France in 2017: a study based on the linkage of data from the National Health Data System

Introduction - This article presents the prevalence of chronic viral hepatitis B (HBV) and C (HCV), excessive alcohol consumption, and metabolic disorders among patients newly diagnosed with and hospitalized for hepatocellular carcinoma (HCC) in mainland France in 2017. Materials and Methods - Data were obtained from the National Health Data System (SNDS). Using ICD-10, CIP/ATC/UCD, and NABM codes, and through data matching, algorithms were developed to identify patients newly diagnosed and treated for HCC in 2017, and the prevalence of HCC risk factors was calculated. Results - In 2017, 7,693 new patients were hospitalized for HCC. The mean age at HCC diagnosis was 69 (standard deviation: 11.2) years. Among patients with HCC, 1,822 (23.7%) had chronic viral hepatitis, including 542 (7.0%) with HBV and 1,280 (16.6%) with HCV. HBV-HCV coinfection was observed in 234 (3.0%) patients. Chronic viral hepatitis was the sole risk factor for HCC in 581 (7.5%) patients. Excessive alcohol consumption, diabetes, or morbid overweight/obesity was found in 5,980 (77.7%) patients. Each of these three risk factors was found alone in 20.8%, 8.3%, and 3.1% of patients with HCC, respectively. Discussion - Excessive alcohol consumption remains the most significant risk factor for HCC in France. Chronic viral hepatitis, whether or not associated with non-infectious risk factors, accounted for nearly 25% of risk factors, even though it is preventable through vaccination or curable with new direct-acting antiviral treatments. The results of this study contribute to expanding epidemiological knowledge of HCC risk factors and assist policymakers in developing health policies regarding HCC management.

Author(s): Kudjawu Yao Cyril, Le Bihan-Benjamin Christine, Brouard Cécile, Leclerc Stéphanie, Cohen-Akenine Annick, Fontaine Hélène, Daubisse-Marliac Laetitia, Bouvier Anne-Marie, Gallay Anne, de Maria Florence

Publishing year: 2020

Pages: 639-648

Weekly Epidemiological Bulletin, 2020, n° 31-32, p. 639-648

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