Trends and Age-Period-Cohort Effects on the Prevalence, Incidence and Mortality of Hepatocellular Carcinoma from 2008 to 2017 in Tianjin, China.

Chengyu Liu,Jing Wu,Zheng Chang

doi:10.3390/ijerph18116034

Abstract

Objectives: China is the country most afflicted by hepatocellular carcinoma in the world. However, little is known about the epidemiology of hepatocellular carcinoma in China. This study aimed to examine the trends of the prevalence, incidence, and mortality of hepatocellular carcinoma in China, and to investigate the effects of age, period, and birth cohort on the epidemiological trend. Methods: The data were obtained from the Urban Employee Basic Medical Insurance claims database (2003–2017) in Tianjin, China, which covers 5.95 million individuals. The average annual percentage change of the prevalence, incidence, and mortality were accessed using joinpoint regression. Age-period-cohort models were produced to quantify the effects of age, period, and cohort. Results: The hepatocellular carcinoma prevalence rate increased by 5.13% annually from 20.12/100,000 in 2008 to 30.49/100,000 in 2017, and the incidence rate was almost unchanged, from 13.91/100,000 in 2008 to 14.09/100,000 in 2017, but mortality decreased by 1.80% annually from 8.18/100,000 in 2008 to 7.34/100,000 in 2017. The age-period-cohort analysis revealed that the prevalence rate was remarkably increased from age 25, peaked in age 60, and decreased at age 70 and over. In the period index, the prevalence rate increased gradually from 2008 to 2016, and decreased a little in 2017. In the cohort index, the prevalence rate decreased approximately linearly from the 1925 cohort to the 1990 cohort. The result for the incidence was similar to the prevalence. The mortality rate increased approximately linearly from age 45 to 85, decreased from the 1925 cohort to the 1990 cohort, but it changed a little with the change of period. Conclusions: The findings of this study could inform the necessity of conducting earlier screening for high-risk individuals and improving the treatment of hepatocellular carcinoma, which may also help to predict future changes in hepatocellular carcinoma epidemiology.

Highlights

Primary liver cancer is one of the most prevalent and deadly cancers worldwide, with about 905,667 new cases and 830,180 deaths occurring in 2020 [1]
The findings of this study could inform the necessity of conducting earlier screening for high-risk individuals and improving the treatment of hepatocellular carcinoma, which may help to predict future changes in hepatocellular carcinoma epidemiology
This study aimed to describe the trends in hepatocellular carcinoma (HCC) prevalence, incidence, and mortality rates over the past decade in Tianjin, Northern China, and to investigate the effects of age, period, and birth cohort on HCC prevalence, incidence, and mortality

Summary

Introduction

Primary liver cancer is one of the most prevalent and deadly cancers worldwide, with about 905,667 new cases and 830,180 deaths occurring in 2020 [1]. China is the country most afflicted by liver cancer in the world, and about half of global newly diagnosed cases and deaths occur in China (410,038 new cases and 391,152 deaths in 2020) [1,2]. In patients with primary liver cancer, the major histological type is hepatocellular carcinoma (HCC), comprising about 90%, followed by intrahepatic cholangiocarcinoma and other rare types [3]. Previous studies have reported worldwide or national trends on HCC epidemiology. Rich et al suggested that the highest incidence of HCC in the world was in Asia and Africa, Int. J.

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