Pediatric Liver Cancer Cases Have Increased Over Last 30 Years

The incidence of pediatric hepatic cancer has increased over the last 30 years in the United States, Australia and Ontario, Canada, according to data published in Cancer.

“Liver cancer continues to remain a global burden, with incidence rates increasing across all ages,” the study authors wrote. “Results from the current study have confirmed observations from other epidemiological studies noting the increasing incidence of hepatic cancers in children.”

Pediatric hepatic cancer is very rare, and as a result it is difficult to identify factors that contributor to its incidence and survival among patients. Identifying trends in pediatric hepatic cancer incidence and survival in Ontario, Canada; the U.S.; and Australia was the main goal of the study. A second goal was to study the patient’s characteristics at time of diagnosis.

The study consisted of 794 children; 148 of which were in Ontario, 400 in the U.S., and 246 in Australia. Children younger than 15 and diagnosed with hepatic cancer between 1985 and 2013 were included in the analysis. The study authors identified the patients using population-based registries and followed them from their time of diagnosis up until Dec. 31, 2015.

Results showed that the average annual incidence of pediatric hepatic cancer increased 2.2% in Australia, 2.1% in the United States, and 1.3% in Ontario. Between diagnosis periods of 1985 through 1994 and 2005 through 2013, the five-year survival rate improved for patients in Ontario (60% to 82%) and in the United States (62% to 78%).The five-year survival rate among patients in Australia, however, did not improve and remained constant (between 74% and 77%). There was no significant difference regarding risk of death between the three locations.

Compared with children diagnosed with hepatoblastoma, a diagnosis of hepatocellular carcinoma was significantly associated with excess death. Presence of metastatic disease and older age at diagnosis were also associated with an increased risk of death within five years of diagnosis. Children aged five to 14 years experienced a great risk of death, whereas children diagnosed at a younger age had a better chance of survival. Sex of the child was not associated with the risk of death.

The authors concluded that survival rates improved over the years due to advancements in therapy and supportive care. There was no clear reason why survival rates in Australia were much higher in the beginning of the study period and remained constant, according to the authors, considering all three locations share membership in international cooperative treatment groups that follow the same protocols.

“Future studies will need to collect additional detailed prognostic information to assess the differences noted in survival between jurisdictions over time,” the authors noted.

The authors highlighted why it’s important to continue collecting data on cancer incidence in children.

“It will be important to continue to use data collected by population-based cancer registries to monitor the apparently increasing incidence of hepatic cancer in children, and any further variations in survival at a population level between jurisdictions, to support research into possible reasons for these trends,” the authors concluded.