{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T17:26:44Z","timestamp":1789925204355,"version":"4.0.1"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2016,9,30]],"date-time":"2016-09-30T00:00:00Z","timestamp":1475193600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1"},{"start":{"date-parts":[[2016,9,30]],"date-time":"2016-09-30T00:00:00Z","timestamp":1475193600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatology"],"published-print":{"date-parts":[[2017,3]]},"abstract":"<jats:p>The Cancer Register (CR) in Sweden has reported that the incidence of primary liver cancer (PLC) has slowly declined over the last decades. Even though all cancers, irrespective of diagnostic method, should be reported to the CR, the PLC incidence may not reflect the true rate. Improved diagnostic tools have enabled diagnosis of hepatocellular carcinoma based on noninvasive methods without histological verification, possibly associated with missed cancer reports or misclassification in the CR. Our objective was to study the completeness and assess the underreporting of PLC to the CR and to produce a more accurate estimate based on three registers. The CR, the Cause of Death Register, and the Patient Register were investigated. Differences and overlap were examined, the incidence was estimated by merging data from the registers, and the number reported to none of the registers was estimated using a log\u2010linear capture\u2010recapture model. The results show that 98% of the PLCs reported to the CR were histologically verified; 80% were hepatocellular carcinoma and 20% were intrahepatic cholangiocarcinoma. Unspecified liver cancer decreased over time and constituted &lt;10% of all reported liver cancers. The CR may underestimate the liver cancer incidence by 37%\u201045%, primarily due to missed cancer reports. The estimated annual number of liver cancers increased over time, but the standardized incidence was stable around 11 per 100,000. Hepatitis C\u2010associated liver cancer increased and constituted 20% in 2010. <jats:italic toggle=\"yes\">Conclusion<\/jats:italic>: There was an underreporting of PLC diagnosed by noninvasive methods; the incidence was considerably higher than estimated by the CR, with a stable incidence over time; reporting needs to improve and combining registers is recommended when studying incidence. (H<jats:sc>epatology<\/jats:sc> 2017;65:885\u2010892).<\/jats:p>","DOI":"10.1002\/hep.28775","type":"journal-article","created":{"date-parts":[[2016,8,17]],"date-time":"2016-08-17T22:52:55Z","timestamp":1471474375000},"page":"885-892","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":40,"title":["The underreporting of hepatocellular carcinoma to the cancer register and a log\u2010linear model to estimate a more correct incidence"],"prefix":"10.1097","volume":"65","author":[{"given":"Anna","family":"T\u00f6rner","sequence":"first","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics,Karolinska Institutet,Stockholm,Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Knut","family":"Stokkeland","sequence":"additional","affiliation":[{"name":"Department of Medicine,Visby Hospital,Visby,Sweden"},{"name":"Department of Medicine, Gastroenterology and Hepatology Unit,Karolinska Institutet,Stockholm,Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c5ke","family":"Svensson","sequence":"additional","affiliation":[{"name":"Department of Mathematics,Stockholm University,Stockholm,Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul W.","family":"Dickman","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics,Karolinska Institutet,Stockholm,Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rolf","family":"Hultcrantz","sequence":"additional","affiliation":[{"name":"Department of Medicine, Gastroenterology and Hepatology Unit,Karolinska Institutet,Stockholm,Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"Montgomery","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology and Biostatistics, School of Medical Sciences,\u00d6rebro University,\u00d6rebro,Sweden"},{"name":"Clinical Epidemiology Unit, Department of Medicine, Solna,Karolinska Institutet,Stockholm,Sweden"},{"name":"Department of Epidemiology and Public Health,University College London,UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann\u2010Sofi","family":"Duberg","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, School of Medical Sciences,\u00d6rebro University,\u00d6rebro,Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2016,9,30]]},"reference":[{"key":"hep28775-bib-0002-20241017","doi-asserted-by":"crossref","first-page":"1118","DOI":"10.1056\/NEJMra1001683","article-title":"Hepatocellular carcinoma","volume":"365","year":"2011","journal-title":"N Engl J Med"},{"key":"hep28775-bib-0003-20241017","doi-asserted-by":"crossref","first-page":"233","DOI":"10.3109\/00365521.2014.990505","article-title":"The future disease burden of hepatitis C virus infection in Sweden and the impact of different treatment strategies","volume":"50","year":"2015","journal-title":"Scand J Gastroenterol"},{"key":"hep28775-bib-0005-20241017","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1080\/02841860802247664","article-title":"The completeness of the Swedish Cancer Register: a sample survey for year 1998","volume":"48","year":"2009","journal-title":"Acta Oncol"},{"key":"hep28775-bib-0006-20241017","doi-asserted-by":"crossref","first-page":"908","DOI":"10.1016\/j.jhep.2011.12.001","article-title":"EASL\u2010EORTC clinical practice guidelines: management of hepatocellular carcinoma","volume":"56","year":"2012","journal-title":"J Hepatol"},{"key":"hep28775-bib-0007-20241017","first-page":"1798","article-title":"Clinical features in hepatocellular carcinoma and the impact of autopsy on diagnosis. A study of 530 cases from a low\u2010endemicity area","volume":"52","year":"2005","journal-title":"Hepatogastroenterology"},{"key":"hep28775-bib-0010-20241017","doi-asserted-by":"crossref","first-page":"450","DOI":"10.1186\/1471-2458-11-450","article-title":"External review and validation of the Swedish national inpatient register","volume":"11","year":"2011","journal-title":"BMC Public Health"},{"issue":"21","key":"hep28775-bib-0011-20241017","article-title":"The epidemiology of hepatitis C virus infection in Sweden","volume":"13","year":"2008","journal-title":"Euro Surveill"},{"key":"hep28775-bib-0012-20241017","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1111\/j.1365-2893.2008.00979.x","article-title":"Hepatocellular carcinoma and other primary liver cancers in hepatitis C patients in Sweden\u2014a low endemic country","volume":"15","year":"2008","journal-title":"J Viral Hepat"},{"key":"hep28775-bib-0013-20241017","doi-asserted-by":"crossref","first-page":"1111","DOI":"10.1097\/00005650-200411000-00010","article-title":"Using Medicare data to estimate the number of cases missed by a cancer registry: a 3\u2010source capture\u2010recapture model","volume":"42","year":"2004","journal-title":"Med Care"},{"key":"hep28775-bib-0014-20241017","doi-asserted-by":"crossref","first-page":"822","DOI":"10.3109\/0284186X.2013.857429","article-title":"Systematic underreporting of the population\u2010based incidence of pancreatic and biliary tract cancers","volume":"53","year":"2014","journal-title":"Acta Oncol"},{"key":"hep28775-bib-0015-20241017","doi-asserted-by":"crossref","first-page":"1220","DOI":"10.3109\/0284186X.2011.599338","article-title":"Pancreatic cancer; reporting and long\u2010term survival in Sweden","volume":"50","year":"2011","journal-title":"Acta Oncol"},{"key":"hep28775-bib-0016-20241017","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1007\/s10552-007-9073-x","article-title":"Interpreting trends of pancreatic cancer incidence and mortality: a nation\u2010wide study in Sweden (1960\u20102003)","volume":"19","year":"2008","journal-title":"Cancer Causes Control"},{"key":"hep28775-bib-0017-20241017","doi-asserted-by":"crossref","first-page":"2085","DOI":"10.1002\/ijc.27462","article-title":"Comparability of cancer identification among Death Registry, Cancer Registry and Hospital Discharge Registry","volume":"131","year":"2012","journal-title":"Int J Cancer"},{"key":"hep28775-bib-0018-20241017","doi-asserted-by":"crossref","first-page":"1205","DOI":"10.1002\/hep.28267","article-title":"Novel population\u2010based study finding higher than reported hepatocellular carcinoma incidence suggests an updated approach is needed","volume":"63","year":"2016","journal-title":"Hepatology"},{"key":"hep28775-bib-0019-20241017","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1002\/hep.22312","article-title":"Trends in mortality from hepatocellular carcinoma in Europe, 1980\u20102004","volume":"48","year":"2008","journal-title":"Hepatology"}],"container-title":["Hepatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fhep.28775","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fhep.28775","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/01515467-201703000-00015","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,18]],"date-time":"2024-10-18T00:34:14Z","timestamp":1729211654000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/01515467-201703000-00015"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,9,30]]},"references-count":15,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2017]]}},"URL":"https:\/\/doi.org\/10.1002\/hep.28775","relation":{},"ISSN":["0270-9139","1527-3350"],"issn-type":[{"value":"0270-9139","type":"print"},{"value":"1527-3350","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,9,30]]},"assertion":[{"value":"2016-03-05","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-07-19","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}