Primary liver cancer: Worldwide incidence and trends
Section snippets
Mortality from liver cancer
Coding recommendations for primary liver cancer and liver metastasis changed slightly from the eighth to the ninth revisions of the International Classification of Diseases (ICD) implemented after 1965 and 1975 respectively.6, 7 The tenth revision was introduced as from 1992.8 The impact of coding practices in mortality statistics is relevant in liver cancer, although its impact has probably been over estimated in relation to the impact of improving diagnostic technology such as ultrasound and
Liver cancer incidence in different ethnic groups and immigrant populations
The incidence of liver cancer in populations by ethnic origin in the United States is shown in Figure 6.12 The lowest incidence rates are consistently found among whites (3.8 in men and 1.4 in women). Gradually increasing rates are found in the Japanese (5.5 in men and 4.3 in women), African American (7.1 in men and 2.1 in women), Hispanic white (9.8 in men and 3.5 in women), Filipino (10.9 in men and 2.4 in women), Chinese (16.2 in men and 5.0 in women), and Korean American (20.7 in men and
Age-specific incidence rates
In most high-risk areas, such as Southeast Asia (Qidong in China) or the West Coast of Africa (Bamako in Mali), rates of liver cancer increase after 20 years of age and peak or stabilize at the age of 50 years and above (Figure 7). In these countries, liver cancer is not a rare event at ages 20 to 35 years. Still, the incidence in Qidong is substantially higher at each age group than the corresponding incidence in Mali, a high-risk country in Africa, and the age of occurrence is significantly
Trends in liver cancer incidence and mortality
International variation in the availability of diagnostic testing as well as in the coding and registration practices for liver cancer (HCC, intrahepatic cholangiocarcinoma, metastases, and liver tumors of uncertain nature as if primary or secondary) makes the interpretation of long-term time trends difficult. Of particular concern in some countries is the likely impact of immigration from high-risk countries. These populations are often visible in the health system at the time of diagnosis but
Risk factors for primary liver cancer
The etiology of primary liver cancer has been largely established, and Table 2 shows current estimates of the attributable fractions for the main risk factors by 3 geographic areas. The broad traits of the epidemiology of primary liver cancer can be interpreted by the natural history of the hepatotropic viral infections and by the patterns of exposure to the key risk factors in each population.
Opportunities for prevention
By the year 2000, HBV vaccination programs had been implemented in 135 countries, including the lesser developed areas in Africa and Asia. A major input from donor agencies has made it possible to provide HBV vaccine to all newborns in the last decade, and such efforts should be encouraged and supported. HBV vaccination trials initiated in the 1980s have already shown the ability of HBV vaccines to prevent the chronic carriage of HBsAg68, 69 and the development of primary liver cancer when
Conclusions
Primary liver cancer remains a major health problem with great geographic variability. Men are consistently more affected than women, and survival is poor worldwide. Increasing trends in incidence in some developed countries, including the United States, suggest an underlying cohort effect linked to HCV and HBV exposures. Reduction of primary liver cancer burden in most developing countries should give priority to HBV vaccination campaigns and to prevention of nosocomial spread of HBV and HCV.
References (72)
- et al.
Time trends and age-period-cohort effects on the incidence of primary liver cancer in a well-defined French population1976–1995
J Hepatol
(1998) - et al.
Increase in primary liver cancer in the UK, 1979–94
Lancet
(1997) - et al.
Changing international trends in mortality rates for liver, biliary and pancreatic tumours
J Hepatol
(2002) Increasing incidence and mortality of primary intrahepatic cholangiocarcinoma in the United States
Hepatology
(2001)- et al.
The role of parenteral antischistosomal therapy in the spread of hepatitis C virus in Egypt
Lancet
(2000) - et al.
The epidemiology of primary liver cancerglobal epidemiology
- et al.
Impact of HBV, HCV and GBV-C/HGV on hepatocellular carcinomas in Europeresults of a European concerted action
J Hepatol
(1998) - et al.
Persistent hepatitis B virus infection in subjects without hepatitis B surface antigenclinically significant or purely “occult”?
Hepatology
(2001) - et al.
Basal core promoter mutations of hepatitis B virus increase the risk of hepatocellular carcinoma in hepatitis B carriers
Gastroenterology
(2003) - et al.
Prevalence of HBV precore/core promoter variants in the United States
Hepatology
(2003)
Hepatitis B and C virus infection, alcohol drinking, and hepatocellular carcinomaa case-control study in Italy
Brescia HCC Study. Hepatology
Role of reproductive factors in hepatocellular carcinomaimpact on hepatitis B- and C-related risk
Hepatology
Diabetes increases the risk of chronic liver disease and hepatocellular carcinoma
Gastroenterology
Long-term efficacy of continuing hepatitis B vaccination in infancy in two Gambian villages
Lancet
Cancer incidence in five continents, Vol.VI
Eur J Cancer
GLOBOCAN 2000Cancer incidence, mortality and prevalence worldwide, Version 1.0
International Classification of Diseases
International Classification of Diseases
International Classification of Diseases
Influence of death certificate errors on cancer mortality trends
J Natl Cancer Inst
EUROCARE-3 summarycancer survival in Europe at the end of the 20th century
Ann Oncol
Studies of cancer in migrant populationsmethods and interpretation
Rev Epidemiol Sante Publique
Cancer mortality among Chinese migrantsa review
Int J Epidemiol
Cancer mortality of Chinese in New York City 1988–1992
Int J Epidemiol
Cancer mortality among Chinese and South-East Asian migrants in France
Int J Cancer
Cancer mortality in East and Southeast Asian migrants to New South Wales, Australia, 1975–1995
Br J Cancer
Cancer mortality in immigrants from the Near East in Australia
Rev Epidemiol Sante Publique
Cancer mortality in African and Caribbean migrants to England and Wales
Br J Cancer
Cancer mortality among Chinese in the United States
J Natl Cancer Inst
Liver cancer in Asian migrants to the United States and their descendants
Cancer Causes Control
Predominant etiologic association of hepatitis C virus with hepatocellular carcinoma compared with hepatitis B virus in elderly patients in a hepatitis B-endemic area
Cancer
Cited by (2240)
Coarse-to-fine registration and time-intensity curves constraint for liver DCE-MRI synthesis
2024, Computerized Medical Imaging and GraphicsValidation of a supplementary condition of eighth AJCC staging system for stage II hepatocellular carcinoma
2023, European Journal of Surgical OncologyLiver transplantation and primary liver cancer in porphyria
2024, Liver InternationalHepatocellular carcinoma incidence and mortality in the usa by sex, age, and race: a nationwide analysis of two decades
2024, Journal of Clinical and Translational Hepatology
Supported by a personal research grant from the “Pla Oncologic de Catalunya” (to R.C.), by a research grant from the “Fondo de Investigaciones Sanitarias de la Seguridad Social” of the Spanish Government (Reference: 01/1569), and from the Instituto de Salud Carlos III of the Spanish Government (grants RTICCC C03/09 and RTICESP C03/10).