Objectives Varying trends in the incidence of liver cancer have been observed in many Asian countries. We conducted this study to examine trends in liver cancer incidence and histological patterns in Sri Lanka.
Materials and Methods All newly diagnosed patients with liver cancer included in Sri Lanka National Cancer Registry during 2001 to 2010 were analyzed.
Statistical Analysis Joinpoint regression analysis was performed. A p-value of less than 0.05 was considered statistically significant.
Results Overall, 1,482 (male:female = 2.7:1; mean age = 57.5 years) liver cancers were analyzed. Majority were hepatocellular carcinomas (n = 1,169; 78.9%), followed by intrahepatic cholangiocarcinomas (n = 100; 6.75%). Highest incidence of liver cancer was observed in 70–74-year age group (5.1/100,000). Overall, the World Health Organization age-standardized rate (ASR) has increased during 2001 to 2004, from 0.6/100,000 (95% confidence interval [CI] = 0.48–0.72) to 1.0/100,000 (95% CI = 0.85–1.15), with an estimated annual percentage change (EAPC) of 17.8 (95% CI = 5.0–46.2); p > 0.05. From 2004 to 2010, a gradual decline in the incidence was observed. ASR in 2010 was 0.96 (95% CI = 0.81–1.1), with an EAPC of –0.9 (95% CI = –6.7 to 5.4); p > 0.05. Similar patterns of incidence change were observed in both genders.
Conclusions Overall, the incidence of liver cancer appears to be steadily declining in Sri Lanka. Similar patterns of incidence change were observed in both genders. The actual decline is likely to be greater as it is likely that diagnostic scrutiny and reporting would have improved during the study period.
Perioperative processes and adherence to scheduled times are crucial for efficient performance in operating theatres. This systematic review investigated the effects of efficient perioperative systems on the timeliness of upstream and downstream processes in surgical care pathways, looking at how these methods could reduce overall patient waiting times for elective surgery. The authors searched PubMed, EMBASE, SCOPUS, Web of Science and Cochrane databases for articles published after 1 January 2014. Both randomised and non-randomised studies were considered. A total of 7543 publications were screened, of which 20 were eligible for analysis. The studies varied widely in design, scope, reported outcomes and overall quality. Analysis demonstrated that a substantial amount of time could be saved through efficient scheduling and planning of perioperative processes, which could reduce overall patient waiting time for elective surgeries. Further evaluation with higher quality study designs and rigour is recommended for firmer conclusions.
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