Abstract
We examined the global incidence and mortality rates of liver cancer, and evaluated the association between incidence/mortality and socioeconomic development (Human Development Index [HDI] and Gross Domestic Product [GDP]) using linear regression analysis. The average annual percent change (AAPC) of the trends was evaluated from join-point regression analysis. The global incidence of liver cancer varied widely by nine-fold, and was negatively correlated with HDI (men: r = −0.232, p = 0.003; women: r = −0.369, p < 0.001) and GDP per capita (men: r = −0.164, p = 0.036; women: r = −0.212, p = 0.007). Its mortality showed a similarly negative correlation with both indices. The greatest incidence rise in men was observed in Poland (AAPC = 17.5, 95% C.I. = 5.6, 30.9) and Brazil (AAPC = 13.2, 95% C.I. = 5.9, 21.0), whereas Germany (AAPC = 6.6, 95% C.I = 2.0, 11.5) and Norway (AAPC = 6.5, 95% C.I. = 3.2, 10.0) had the greatest increase in women. The mortality rates paralleled the incidence rates in most countries. For mortality, Malta (AAPC = 11.5, 95% C.I. = 3.9, 19.8), Australia (AAPC = 6.8, 95% C.I. = 2.2, 11.5) and Norway (APCC = 5.6, 95% C.I. = 2.8, 8.5) reported the biggest increase among men; whilst Australia (AAPC = 13.4, 95% C.I. = 7.8, 19.4) and Singapore (AAPC = 7.7, 95% C.I. = 4.1, 11.5) showed the most prominent rise among women. These epidemiological data identified countries with potentially increasing trends of liver cancer for preventive actions.
Highlights
Liver cancer is the fifth commonest cancer in 2012, accounting for 9.1% of all cancer deaths worldwide[1]
The highest were found in Eastern Asia (ASR 31.9 per 100,000), South-Eastern Asia (22.2), Northern Africa (18.0) and Western Africa (16.4), and the lowest were reported in South-Central Asia (3.7), Eastern Africa (4.9) and Western Asia (5.0) (Table 1)
The highest were found in Eastern Asia (ASR 10.2 per 100,000), Western Africa (8.1), Melanesia (7.6) and South-Eastern Asia (7.2), and the lowest were reported in Micronesia/Polynesia (1.4), Northern Europe (1.8), Central and Eastern Europe (2.0) and South-Eastern Asia (2.1) (Table 2)
Summary
Liver cancer is the fifth commonest cancer in 2012, accounting for 9.1% of all cancer deaths worldwide[1]. Some of its etiological factors, including hepatitis infection and cirrhosis, are detectable by screening which can minimize development of liver cancer. Previous studies describing the international trends of liver cancer were based on figures from registries in late 1990s to early 2000s; did not take into account the socioeconomic development of each country when comparisons were made; and depended on comparison among countries in a single calendar www.nature.com/scientificreports/. Evaluating and analyzing the patterns and temporal trends of this cancer could quantify geographical variation, identify high-risk populations, delineate the extent of preventive strategies implemented, and might provide further insights into disease etiology. These epidemiological data could be linked to the future prospects of cancer prevention and possibly screening strategies for policy-makers. We tested the a priori hypothesis that the incidence and mortality of liver cancer, respectively, were associated with differences in socioeconomic development and productivity across different countries
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