How Deprivation Influences The Incidence And Survival Of Hcc Patients In The West Of Scotland

Introduction Hepatocellular carcinoma (HCC) is rising in incidence both in Scotland and the UK.1 This study set out to examine whether there is an association between deprivation and the incidence of HCC and survival following diagnosis in the West of Scotland. Methods Data was collected on patients from the prospectively collected West of Scotland regional HCC database from November 2014 to August 2017. Patients were included if they had a new diagnosis of HCC not previously diagnosed or treated elsewhere. Data on deprivation was taken from the Scottish Index of Multiple Deprivation (SIMD) 2016 Data was collected on Excel and the statistical analysis was performed using R. Chi squared, unpaired t-test and log rank tests were used as appropriate. Incidence rates were age adjusted using the European standard population. Results 357 patients were included in the study. 45% of all new cases of HCC were in patients living in the most deprived 20% postcodes. There was a higher incidence rate in patients in SIMD quintile 1 (most deprived) compared with quintile 5 (least deprived) (10.3 vs 5.5 per 100,000, respectively, p Patients in SIMD quintile 1 were younger compared with those in SIMD quintile 5, with a mean age 65.4 yrs vs 69.5 yrs respectively, p = 0.027). A significantly higher proportion of people in SIMD quintile 1 had HCV as the aetiology of their cirrhosis compared with SIMD quintile 5 (30% vs 7%, respectively, p = 0.01). There was no significant difference in patients with alcohol as the aetiology between SIMD quintile 1 and 5 (48% vs 50%, respectively, p = 0.6). Following diagnosis there was no significant difference in survival between patients in the most deprived and least deprived quintiles (median survival 368 days vs 325 days, p = 0.8). The only predictors of survival after diagnosis of HCC were BCLC stage (p Conclusions In contrast to previous studies, we found a higher incidence of HCC in both men and women living in the most deprived areas.1 The proportion of HCC patients with HCV (but not alcohol) as the aetiology of cirrhosis was higher in the most deprived compared with least deprived quintile. Following diagnosis of HCC, we found no difference in survival between patients living in the most and least deprived areas. Reference Cancer Research UK. Liver cancer incidence statistics. https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/liver-cancer/incidence (accessed 19/1/2020). Age adjusted incidence ratesSave