Diagnostic Accuracy of Primary Liver Cancer: Implications for Cancer Registration

Aims and background We evaluated some standardized criteria for classifying incident cases of liver cancer into either primary liver cancer (PLC) or unspecified liver cancer (ULC) on the basis of the diagnostic examinations performed and their results. Methods A pilot hospital-based study (98 cases) was carried out in Verona, northern Italy, with the main aim of assessing the feasibility of the method. The same procedures were subsequently applied in a population-based study (349 cases) in Brescia, northern Italy. Results Diagnosis was made on histologic data in 38.7% and 41.8% of the hospital based and population-based studies, respectively, with a wide variation among different hospitals. The percentage of cases classified as PLC was 78.6% in the hospital-based study and 78.8% in the population-based study. No differences in the proportion of cases attributed to PLC were found according to patients’ age and sex or hospital of admission. The repeatibility of the procedure was assessed by a cross-panel review of 198 cases, and concordance was found in 91.9% of them. Conclusions An operational method for case definition of PLC based on the results of the diagnostic examinations currently performed and some suggestions for cancer registration are proposed.

[1]  Y. Chung,et al.  Specificities of serum α‐fetoprotein in HBsAg+ and HBsAg− patients in the diagnosis of hepatocellular carcinoma , 1991 .

[2]  I B Anderson,et al.  Increase in incidence of disease due to diagnostic drift: primary liver cancer in Denmark, 1943-85. , 1991, BMJ.

[3]  J. G. Bova,et al.  Review of hepatic imaging and a problem‐oriented approach to liver masses , 1990, Hepatology.

[4]  J. Ferrucci.  Liver tumor imaging. Current concepts. , 1990, Radiologic clinics of North America.

[5]  L. Cavanna,et al.  Ultrasonically guided fine-needle aspiration biopsy: a highly diagnostic procedure for hepatic tumors. , 1990, The American journal of gastroenterology.

[6]  M. Makuuchi,et al.  The diagnosis of small hepatocellular carcinomas: efficacy of various imaging procedures in 100 patients. , 1990, AJR. American journal of roentgenology.

[7]  Sachiko Tanaka,et al.  Recent advances in ultrasonographic diagnosis of hepatocellular carcinoma , 1989, Cancer.

[8]  M. Tatsuta,et al.  Diagnostic accuracy of ultrasonography for hepatocellular carcinoma , 1986, Cancer.

[9]  M. Tatsuta,et al.  Cytohistologic diagnosis of neoplasms of the liver by ultrasonically guided fine‐needle aspiration biopsy , 1984, Cancer.

[10]  R. Manconi,et al.  Inaccuracy of death certificate diagnoses in malignancy: an analysis of 1,405 autopsied cases. , 1982, Human pathology.

[11]  S. Franceschi.  Cancer in Italy. Incidence Data from Cancer Registries, 1983–1987, R. Zanetti, P. Crosignani (Eds.). Associazione Italiana di Epidemiologia, Torino, Lega Italiana per la Lotta Contro i Tumori (1992) , 1993 .

[12]  L. Cavanna,et al.  Diagnostic aspects and follow-up of 174 cases of hepatocellular carcinoma. Second report. , 1991, Oncology.

[13]  E. Grundmann,et al.  Autopsy diagnosis versus clinical diagnosis, particularly in malignant disease. Comparison of two periods: 1961-70 and 1978-87. , 1991, IARC scientific publications.

[14]  L. Tomatis,et al.  Cancer : causes, occurrence and control , 1990 .

[15]  J. Ferrucci,et al.  Liver tumor imaging: current concepts. , 1990, AJR. American journal of roentgenology.

[16]  R Weissleder,et al.  Primary liver tumors: diagnosis by MR imaging. , 1989, AJR. American journal of roentgenology.

[17]  P. Pisani,et al.  Estimating incidence of cancer from a hospital discharge reporting system. , 1986, Revue d'epidemiologie et de sante publique.