Background & Aims
Trends in hepatocellular carcinoma (HCC) mortality rates have increased over recent
decades in most countries. It is also the third cause of cancer death worldwide. The
aim of this study is to update global trends in HCC mortality to 2014, and predict
trends in rates in the EU, USA and Japan to 2020.
Methods
Death certification data for HCC over the 1990–2014 period from the World Health Organization
database were analyzed. Sixteen European, five American countries, and six other countries
worldwide were included, as well as the EU as a whole.
Results
In European men, mortality rates were stable during the last decade (3.5/100,000).
HCC mortality increased in Northern and Central Europe, and decreased in Southern
Europe. In the USA, HCC mortality increased by 35% between 2002 and 2012, reaching
3.1/100,000 men in 2012; it is predicted to remain stable to 2020. Reduced mortality
rates were observed in East Asia, although they remained around 10–24/100,000 men.
In Japan, HCC mortality is predicted to decrease (5.4/100,000 men in 2020). Trends
were favorable in the young, but unfavorable in middle aged, except in East Asia.
Mortality rates were 3- to 5-fold lower in women than men in most regions, but trends
were similar.
Conclusions
Control of hepatitis B (HBV) and hepatitis C virus (HCV) infections has contributed
to the decrease in HCC-related mortality in East Asia and Southern Europe. Unfavorable
trends in other regions can be attributed to HCV (and HBV) epidemics in the 1960s
and 1980s, alcohol consumption, increased overweight/obesity, and diabetes. Better
management of cirrhosis, HCC diagnosis and treatment are also influencing the mortality
trends worldwide.
Lay summary
Mortality rates due to HCC have increased in many countries over recent decades. In
this study, we updated worldwide mortality trends for HCC from 1990 to 2014, and predicted
trends for some countries to 2020. We observed unfavorable trends in Northern and
Central Europe, North and Latin America. East Asia showed an improvement, however
mortality rates in this region were 2- to 5-fold higher than in most European countries
and the Americas. Steady declines to 2020 are predicted for East Asia but not for
Europe and the Americas.
Graphical abstract
Graphical Abstract
Keywords
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Article info
Publication history
Published online: March 20, 2017
Accepted:
March 13,
2017
Received in revised form:
February 14,
2017
Received:
December 7,
2016
See Editorial, pages 216–217Identification
Copyright
© 2017 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
