New Insights in the Management of Hepatocellular Adenoma

Anne J. Klompenhouwer; Robert A. de Man; Marco Dioguardi Burgio; Valerie Vilgrain; Jessica Zucman-Rossi; Jan N. M. Ijzermans

Disclosures

Liver International. 2020;40(7):1529-1537. 

In This Article

Epidemiology

For a long time, epidemiological data on HCA were severely outdated. In 1979, the annual incidence rate was estimated at 3–4 per 100.000 women per year for long-term OC users, as compared to 0.1 per 100.000 women per year for non-long-term users.[12] The next study concerning the epidemiology of HCA was not published until 2017. This was a nationwide registry-based cohort study from Denmark.[13] The authors investigated the incidence of hepatocellular adenoma and found a standardized incidence rate of biopsy-confirmed adenomas of 0.07 per 100.000 population per year (0.02 per 100.000 for men and 0.13 for women). The true incidence rate, however, will probably be higher as only patients with biopsy-confirmed HCA were included in this study. It is likely to assume that the incidence has increased since 1979 as HCA are more often incidentally found due to the more widespread use of imaging techniques. Additionally, the obesity epidemic may have led to an increase in the incidence of HCA.[3,4,14] Epidemiological data on HCA from Europe and the United States have seldom been compared to data from continents where both the use of oral contraceptives and the incidence of obesity is lower. A recent single-centre study from Taiwan showed that the local incidence of HCA increased over the last decade and that the clinical features differ from those reported in Europe and the United States.[15] For instance, they found a male predominance in their cohort. It would be very interesting to further explore these differences in epidemiological data.

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