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Global trends and predictions in hepatocellular carcinoma mortality

Published:March 20, 2017DOI:https://doi.org/10.1016/j.jhep.2017.03.011

      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

      Keywords

      Linked Article

      • Reply to: “How to predict global trends in HCC mortality if neglect more than half the world’s cases?”
        Journal of HepatologyVol. 67Issue 4
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          We thank Dr. Sun for their interest in our work, and agree that China is the “great country of liver cancer”, a major site showing upward trends in several areas of the world.1 We also agree that it is difficult to predict trends in hepatocellular carcinoma (HCC) mortality in China, given the different evolving trends of its main risk factors, i.e. hepatitis B and C, non-alcoholic fatty liver disease, diabetes and alcohol use.2 We also appreciate the additional data they provided on liver cancer in China.
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      • How to predict global trends in HCC mortality if neglecting more than half the world’s cases?
        Journal of HepatologyVol. 67Issue 4
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          We read with great interest the article by Bertuccio et al.,1 and appreciate their meaningful work. Using the World Health Organization database on death certification, this study analyzed the data for hepatocellular carcinoma (HCC) over the period of 1990–2014. Sixteen European, five American countries, and six other countries worldwide were included, as well as the European Union (EU) as a whole. The authors claimed that their study has updated the worldwide trends for HCC mortality and made predictions for the trends of 2020.
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