Trends Of Liver Cancer Research Articles

Projected epidemiological trends and burden of liver cancer by 2040 based on GBD, CI5plus, and WHO data

Incidence of liver cancer as one of the most common cancers worldwide and become the significant contributor for the mortality among cancer patients. The disease burden, risk factors, and trends in incidence and mortality of liver cancer globally was described subsequently estimated the projections of liver cancer incidence or mortality by 2040. Data regarding age-standardized incidence and mortality rates for liver cancer was obtained from multiple databases, including GLOBOCAN 2020, CI5 volumes I–XI, WHO mortality database, and Global Burden of Disease (GBD)-2019. Concentrating on worldwide variations, this thorough analysis offers insights into patterns of incidence and mortality based on gender and age. Our findings encompass significant indicators, including age-standardized rates (ASRs), average annual percentage change (AAPC), and future projections extending up to the year 2040. Liver cancer holds the sixth position in terms of most frequently diagnosed cancers and stands as the sixth leading cause of cancer-related deaths worldwide in 2020, accounting for 905,677 new cases and 782,000 fatalities. Additionally, liver cancer contributed to 12,528,421 age-standardized disability-adjusted life years (DALYs), with an age-standardized DALYs rate of 161.92 in 2019 worldwide. The age-specific incidence rates exhibited significant variations across different regions, showing a fivefold difference in males and females. A significant increase in incidence was observed in North Europe and Asia, while North African countries reported a higher mortality burden (ASR, 10 per 100,000) compared to developed countries. Since last few years, the incidence and mortality rates have increased and attained Annual Average Percentage Change (AAPC) incidence rate of 7.7 (95% CI 3.9–11.6) for men and the highest AAPC mortality rate of 12.2 (95% CI 9.5–15.0) for women. In 2019, Western Europe emerged as the high-risk region for DALYs related to smoking and alcohol consumption, while high-income North America carried a high risk for DALYs associated with a high body-mass index. The projected trend indicates a surge in new liver cancer incident cases, expected to rise from around 905,347 to an estimated 1,392,474 by 2040. This study described the evidence pertinent to higher incidence trends in liver cancer, particularly among both young and older adults, encompassing males and females, as well as those who are HIV-infected and HBsAg positive. A significant rise in the young population poses a significant public health concern that warrants attention from healthcare professionals to prioritize the promotion of health awareness and the development of effective cancer prevention strategies, particularly in many developing countries.

Liver Cancer in the Middle East and North Africa: Epidemiology, Trends, and Risk Factors

Objectives: Considering the growing concerns about the rising incidence of this cancer in the Middle East and North Africa (MENA), this literature review presents the local epidemiology and trends of liver cancer, along with a practical estimation of its epidemiology and contributing risk factors. Design: Review Article. Setting(s): Middle East and North Africa. Outcome Measures: MEDLINE (via PubMed), Scopus, and Web of Science databases, as well as Google Scholar, were searched up to September 2024 using representative keywords and MeSH terms. Studies reporting the epidemiology of liver and intrahepatic cholangiocarcinoma in the region or an analysis of the contributing infectious diseases, non-communicable disorders, genetic predispositions, behavioral aspects, and environmental factors were included. A qualitative synthesis was performed, and the results were presented using thematic narrative synthesis. Results: Liver cancer, particularly hepatocellular carcinoma (HCC), is rapidly growing in the MENA region, driven by a combination of viral hepatitis, underlying metabolic disorders, and environmental exposures. Liver cancer epidemiology varies across the region, with countries like Egypt historically burdened by hepatitis C, while Gulf states experience rising cases linked to metabolic disorders. Projections indicate a continued increase in the incidence of liver cancer due to the ongoing obesity and diabetes epidemics. Conclusions: Despite the success of viral hepatitis management campaigns in some countries, the region faces significant challenges in controlling the rising burden of liver cancer related to metabolic disorders. Prevention strategies should focus on lifestyle and dietary interventions, alongside the need for improved cancer registries, better data collection, and policy reforms. A multidisciplinary approach, combining public health initiatives and targeted healthcare improvements, is essential to reduce regional liver cancer incidence and improve outcomes.

Changing global epidemiology of chronic hepatitis C virus-related outcomes from 2010 to 2019: cirrhosis is the growing burden of hepatitis C virus-related disease.

Chronic infection with hepatitis C virus (HCV) has a long-term impact on hepatic consequences. A comprehensive evaluation of the global burden of HCV-related health outcomes can help to develop a global HCV prevention and treatment program. We used the 2019 Global Burden of Disease (GBD) Study to comprehensively investigate burden and temporal trends in incidence, mortality and disability-adjusted life-years (DALYs) of HCV-related diseases, including liver cancer and cirrhosis and other liver diseases across 264 countries and territories from 2010 to 2019. Globally, there were 152 225 incident cases, 141 811 deaths and approximately 2.9 million DALYs because of HCV-related liver cancer, and 551 668 incident cases, 395 022 deaths and about 12.2 million DALYs because of HCV-related cirrhosis in 2019. Worldwide, during the 2010-2019 period, liver cancer incidence declined, however, there was a 62% increase in cirrhosis incidence. In 2019, the Eastern Mediterranean was the region with the highest rates of incidence and mortality of both liver cancer and cirrhosis. Africa was the region with the fastest-growing trend of incidence of cirrhosis in the 2010-2019 period [annual percentage change (APC) = 2.09, 95% confidence interval (CI): 1.93-2.25], followed by the Western Pacific region (APC = 1.17, 95% CI: 1.09-1.22). Americas were the only region observing increased trends in liver cancer and cirrhosis mortality (APC = 0.70 and 0.12, respectively). We identified three patterns of temporal trends of mortality rates of liver cancer and cirrhosis in countries that reported HCV treatment rates. Urgent measures are required for diagnosis, treatment and research on HCV-related cirrhosis at global, regional and country levels, particularly in Africa, the Western Pacific and the Eastern Mediterranean.

Long-term survival trends for primary liver and pancreatic cancers in the Nordic countries

Liver cancer (LC) and pancreatic cancer (PC) are often diagnosed at an advanced stage resulting in high mortality. High-quality survival data are rarely available for trend analyses over a long period. The Danish, Finnish, Norwegian, and Swedish cancer data were accessed at the NORDCAN database. We analysed relative 1- and 5-year survival trends in LC and PC between years 1970 and2019. Relative 1-year survival in LC for Nordic men and women was about 10% in the period between 1970 and 1974, and it increased moderately by year 2000 and steeply thereafter, eventually reaching 40-50%. The patterns in 5-year survival were similar, but after the year 2000, survival in Norway and Sweden increased steeply to 23%, whereas survival in Denmark and Finland lagged behind, reaching 10% to 15%. The patterns for PC also showed rapid improvement after the year 2000, with 1-year survival reaching 30% to 40% and 5-year survival reaching 10% for Finland and 15% for Norway and Sweden. Survival was best for patients diagnosed before age 50 years, and it was worst for older patients. For both cancers the difference between 1- and 5-year survival increased with time. Survival in LC and PC improved first modestly and then steeply over the 50-year period covered. The increase in 5-year survival was less than that of 1-year survival. The survival gains were most likely the result of earlier diagnosis, improved treatment, and better organised supportive care. The challenges are to keep up these positive trends, to extend survival benefits past Year 1, and to obtain similar results in elderly patients. Primary prevention through avoidance of risk factors would reduce case numbers. Liver and pancreatic cancers are among the most lethal of all cancers. In 50 years, survival in these cancers has slowly improved, and in the past 20 years, the development has been increasingly favourable. Widespread adoption of healthy lifestyles will be key to reducing the risk of these cancers.

Decrease in liver cancer incidence rates in Bamako, Mali over 28 years of population-based cancer registration (1987-2015).

BACKGROUNDPrimary liver cancer is common in West Africa due to endemic risk factors. However, epidemiological studies of the global burden and trends of liver cancer are limited. We report changes in trends of the incidence of liver cancer over a period of 28 years using the population-based cancer registry of Bamako, Mali.AIMTo assess the trends and patterns of liver cancer by gender and age groups by analyzing the cancer registration data accumulated over 28 years (1987-2015) of activity of the population-based registry of the Bamako district.METHODSData obtained since the inception of the registry in 1987 through 2015 were stratified into three periods (1987-1996, 1997-2006, and 2007-2015). Age-standardized rates were estimated by direct standardization using the world population. Incidence rate ratios and the corresponding 95% confidence intervals (CI) were estimated using the early period as the reference (1987-1996). Joinpoint regression models were used to assess the annual percentage change and highlight trends over the entire period (from 1987 to 2015).RESULTSAmong males, the age-standardized incidence rates significantly decreased from 19.41 (1987-1996) to 13.12 (1997-2006) to 8.15 (2007-2015) per 105 person-years. The incidence rate ratio over 28 years was 0.42 (95%CI: 0.34-0.50), and the annual percentage change was -4.59 [95%CI: (-6.4)-(-2.7)]. Among females, rates dropped continuously from 7.02 (1987-1996) to 2.57 (2007-2015) per 105 person-years, with an incidence rate ratio of 0.37 (95%CI: 0.28-0.45) and an annual percentage change of -5.63 [95%CI: (-8.9)-(-2.3)].CONCLUSIONThe population-based registration showed that the incidence of primary liver cancer has steadily decreased in the Bamako district over 28 years. This trend does not appear to result from biases or changes in registration practices. This is the first report of such a decrease in an area of high incidence of liver cancer in Africa. This decrease may be explained by the changes and diversity of diet that could reduce exposure to aflatoxins through dietary contamination in this population.

Gender disparity and temporal trend of liver cancer in China from 1990 to 2019 and predictions in a 25-year period.

ObjectiveThis study aims to reveal epidemiological features and trends of liver cancer (LC) in China.MethodsWe retrieved data from the Global Burden of Disease database 2019. Joinpoint regression was used to examine the temporal trend of LC. Future trends of LC were estimated using the Nordpred.ResultsThe incidence, mortality, and disability-standardized life year (DALY) rate of LC declined in China from 1990 to 2019. Among >210,000 LC cases in 2019, the LC incidences were nearly 3.15 times higher in males than in females. LC cases and LC-associated deaths were mostly found among patients aged 65 to 69 years. The proportion of LC attributable to hepatitis B decreased over time, whereas the proportions of LC attributable to hepatitis C, alcohol use, and non-alcoholic steatohepatitis increased modestly from 1990 to 2019. The majority of LC-associated deaths could be traced to four risk factors: smoking (20%), drug use (13.6%), alcohol use (11.7%), and high body mass index (10.1%). Based on the Nordpred prediction, there will be a steady decline in the incidence (39.0%) and mortality (38.3%) of liver cancer over a 25-year period from 2020 to 2044.ConclusionThe disease burden of liver cancer in China has declined over the past 30 years. However, it remains important to control liver cancer among high-risk populations, especially elderly males with obesity, alcohol use, tobacco use, and/or drug abuse.

Long-term incidence in hepatocellular carcinoma and intrahepatic bile duct cancer in Denmark, Finland, Norway and Sweden, role of Thorotrast?

We analyzed long-term incidence trends in liver cancer (including hepatocellular carcinoma and intrahepatic cholangiocarcinoma) with an aim to interpret the changes in terms of known risk factors and hypothesize that historical exposure to Thorotrast, a radiographic contrast medium emitting alpha particles, has changed population rates. The NORDCAN database was used to collect cancer registry data from Denmark (DK), Finland (FI), Norway (NO) and Sweden (SE), which we used from 1953 (DK, FI and NO) and 1960 (SE) through 2019. Thorotrast, which caused a 100-fold risk of liver cancer was used in DK and SE, and probably also in FI between 1930 and 1950, but not in NO. The incidence trend for liver cancer showed a broad maximum at around 1980, most prominent and statistically significant in SE and DK men and women, and in all countries, a steadily increasing trend towards the end of follow-up. Incidence for NO was lower than for the other countries and the rates showed no peaking at around 1980. Birth cohort analysis identified a transient risk which could be dated to a period between 1930 and 1950 in countries other than NO. Considering a lag time between Thorotrast use and liver cancer appearance, the large incidence peak around 1980 in DK and DE was probably contributed by Thorotrast but considering the ecological nature of the findings, the association should be considered cautiously as hypothesis generating. The late increase in liver cancer risk is most likely lifestyle related and largely preventable.

The impact of universal hepatitis B vaccine on the trend of liver cancer from the Global Burden of Disease Study 2017.

This study aims to assess the trend of hepatitis B virus (HBV)-attributable liver cancer as well as the impact of HBV vaccine on it. We retrieved data from Global Burden Disease study to estimate trends of HBV-attributable liver cancer by region and age from 1990 to 2017 and HBV vaccine data from World Health Organization to assess its impact on these trends for children (0-14years), adolescents and young adults (15-29years). Change of cancer cases, age-standardized incidence rate (ASR) and estimated annual percentage change (EAPC) were used to quantify the trends of HBV-attributable liver cancer. In this study, reduction in HBV-attributable cancer incident cases was found among children (from 2080 to 1430), adolescents and young adults (from 10890 to 9090). In terms of ASR, overall reduction was observed globally by an average of -0.45% (95% CI: -0.62 to -0.29) per year in the same period. The highest reduction in ASR was found in adolescents and young adults with EAPC of -3.02 (95% CI: -3.57 to -2.46). Although the ASR has decreased from all the five regions with universal HBV immunization programme, it has increased in the region without universal vaccination and the highest increase was found among children with EAPC of 1.97 (95% CI: 1.71-2.23). Significant reduction in HBV-attributable liver cancer among children was mainly because of the universal HBV vaccination. However, the increasing trend of HBV-attributable liver cancer in region without universal HBV vaccination suggested the necessity of introducing universal immunization.

The Burden and Trends of Primary Liver Cancer Caused by Specific Etiologies from 1990 to 2017 at the Global, Regional, National, Age, and Sex Level Results from the Global Burden of Disease Study 2017

Background: Liver cancer is one of the leading causes of cancer-related deaths worldwide. The primary causes of liver cancer include hepatitis B virus (HBV), hepatitis C virus (HCV), alcohol consumption, nonalcoholic fatty liver disease, and other factors. Aims: The objective of this study was to evaluate the global and sex-, age-, region-, country-, and etiology-related liver cancer burden, as well as the trends in liver cancer caused by different etiologies. Methods: The causes of liver cancer from 1990 to 2017, including global, regional, and national liver cancer incidence, mortality, and etiology, were collected from the Global Burden of Disease study 2017, and the time-dependent change in the trends of liver cancer burden was evaluated by annual percentage change. Results: The global liver cancer incidence and mortality have been increasing. There were 950,000 newly-diagnosed liver cancer cases and over 800,000 deaths in 2017, which is more than twice the numbers recorded in 1990. HBV and HCV are the major causes of liver cancer. HBV is the major risk factor of liver cancer in Asia, while HCV and alcohol abuse are the major risk factors in the high sociodemographic index and high human development index regions. The mean onset age and incidence of liver cancer with different etiologies have gradually increased in the past 30 years. Conclusions: The global incidence is still rising and the causes have national, regional, or population specificities. More targeted prevention strategies must be developed for the different etiologic types in order to reduce liver cancer burden.

Top 100 most frequently cited papers in liver cancer: a bibliometric analysis.

Bibliometric analysis has become popular in recent years, and increasingly more articles focusing on a particular disease are being published. The present study was performed to analyse the 100 most frequently cited papers in liver cancer (LC). We searched the Thomson Reuters Web of Science database on 14 July 2018 to identify all potential manuscripts for this study. The search terms were 'liver cancer' and its synonyms. Manuscripts were listed in descending order by the total citations (TCs), and the 100 most frequently cited papers were identified and analysed by topic, journal, author, year and institution. We retrieved 235 687 papers from the Web of Science database. The TC of the 100 most frequently cited papers in LC ranged from 612 to 5358. The 100 papers were published in 31 journals and came from nine countries. The University of Barcelona published the highest number of papers and had the most TC. Ten authors published more than one paper. Treatment of LC was the most widely studied topic. A significant correlation was found between the journal's 2017 impact factor and the TC (P = 0.003). We assessed the landmark papers in the field of LC. These 100 most frequently cited papers reflect major advances and several hot topics in LC during the recent decades. Our study is of great value for young investigators, provides insights into the trends of LC and can guide directions for future academic research.

Changing trends in the disease burden of primary liver cancer caused by specific etiologies in China.

BackgroundLiver cancer is a commonly diagnosed malignancy in China. The etiologies of liver cancer are widely known, although studies on temporal trends in liver cancer caused by specific etiologies are rare.MethodsData on the incidence and mortality of liver cancer were retrieved from the Global Burden of Diseases Study 2017. The estimated annual percentage change (EAPC) was used to quantify temporal trends in the age‐standardized incidence rate (ASIR) and the age‐standardized mortality rate (ASMR) of liver cancer from 1990 to 2017.ResultsNationwide, the number of incident cases of liver cancer increased from 258 000 in 1990 to 515 900 in 2017. The ASIR decreased from 27.16 per 100 000 to 26.04 per 100 000 during this period, with an EAPC of −0.64 (95% confidence interval [CI] −0.84, −0.44). The number of deaths increased from 245 300 in 1990 to 418 200 in 2017, and the ASMR decreased from 26.72 to 21.30 (EAPC = −1.16, 95% CI −1.35, −0.97). The most pronounced decreases in the ASIR and ASMR were observed in liver cancer due to hepatitis B and in people aged 15‐49 years.ConclusionsSince the extensive efforts for prevention of hepatitis B virus infection, the incidence of liver cancer due to hepatitis B has significantly decreased. However, liver cancer due to hepatitis C, NASH, and other causes remains a major public health concern. Additional preventive strategies tailored to liver cancer are needed to further reduce its disease burden in China.

The Incidence of Hepatocellular Carcinoma in Iran from 1996 to 2016: a Systematic Review and Meta-analysis.

Hepatocellular carcinoma or liver cancer (LC) is one of most important cancer around the world. There are several reports about LC incidence from various Iranian locations with conflicting results. The present study aimed to accomplish a systematic review to estimate the accurate incidence rate of LC among Iranian people. This systematic review was performed based on the preferred reporting items for systematic reviews and meta-analyses (PRISMA) checklist in 2018. A literature search was conducted using international databases (Medline/PubMed, Scopus, ScienceDirect, and Google Scholar) for English papers and national databases (Scientific Information Database, MagIran, IranMedex, and IranDoc) for Persian papers which estimated incidence rate of LC in any geographical area of Iran. The incidence rate of LC was calculated using random effect model. Of 171 papers in the primary searches, 15 studies were included by advanced screening and refinement. The age-standardized rate (ASR) of LC was 1.66 (95% CI 1.49-1.83) for males and 1.25 (95% CI 1.12-1.38) for females. The incidence rate of LC in Iran was lower in comparison to other countries. Afterwards, more studies are necessary to outline the accurate incidence rate and the trend of LC among Iranian population.

The Burden and Trends of Primary Liver Cancer Caused by Specific Etiologies from 1990 to 2017 at the Global, Regional, National, Age, and Gender Level Results from the Global Burden of Disease Study 2017

Background: Liver cancer is one of the leading causes of cancer-related deaths worldwide. The primary causes of liver cancer include hepatitis B virus (HBV), hepatitis C virus (HCV), alcohol consumption, non-alcoholic fatty liver disease, and other factors. The objective of this study was to evaluate the global, and gender-, age-, region-, country- and etiology-related liver cancer burden, as well as the trends in liver cancer caused by different etiologies. Methods: The causes of liver cancer from 1990 to 2017, including global, regional and national liver cancer incidence, mortality and etiology, were collected from the Global Burden of Disease study 2017, and the time-dependent change in the trends of liver cancer burden was evaluated by annual percentage change. Findings: The global liver cancer incidence and mortality have been increasing. There were 950,000 newly-diagnosed liver cancer cases and over 800,000 deaths in 2017, which are more than twice the numbers recorded in 1990. HBV and HCV are the major causes of liver cancer, and responsible for nearly 70% of the global liver cancer-related deaths and incidents. HBV is the major risk factor of liver cancer in Asia, while HCV and alcohol abuse are the major risk factors in the high SDI and high HDI regions. Liver cancer incidence and mortality are three times higher in males than in females, and the global liver cancer burden is highest among individuals order than 50 years. HBV is the main cause of liver cancer in individuals younger than 20 years. The mean onset age and incidence of liver cancer with different etiologies have gradually increased in the past 30 years. Interpretation: Liver cancer is a common malignancy with a high global disease burden. Although the implementation of public health measures such as hepatitis B immunization has reduced the incidence of liver cancer in some countries or territories, the global incidence is still rising and the causes have national, regional or population specificities. Therefore, more targeted prevention strategies must be developed for the different etiological types in order to reduce liver cancer burden. Funding Statement: This study was financially supported by the Fundamental Research Funds for the Central public welfare research institutes (ZXKT17013, ZZ11-092 and ZZ13-YQ059), and Young Elite Scientists Sponsorship Program by CACM(2018QNRC2-C01). Declaration of Interests: The authors declare that they have no conflicts of interest. Ethics Approval Statement: Not required.

Effect of Population-Wide Hepatitis B Vaccination in Preventing Liver Cancer Among Children and Young Adults in the United States

Background: Liver cancer is the second most common cause of death from cancer worldwide1. In 2013, 79,2000 new cases of liver cancer and 818,000 deaths occurred globally2,3. Chronic infection with HBV accounts for at least 50% of liver cancer globally4. In the United States (US), liver cancer constitute the ninth leading cause of cancer death. The incidence of the cancer has persistently increased in the recent decades. Universal HBV vaccination was introduced in 1992 in the US. However, incidence trends of liver cancer among US children is poorly researched or relevant studies are not up-to-date5. Aim: This study aims to explore the effect of HBV population-wide vaccination program in reducing liver cancer incidence in the vaccinated children and adolescents in the US. Methods: Liver cancer incidence data were obtained from Cancer Incidence in Five Continents (CI5) databases (volumes I to X) from International Agency for Cancer Research (IARC). Data acquisition and analysis covered available incidence data between 1978-2007 from 9 cancer registries from Surveillance, Epidemiology, and End Results Program (SEER) from the US presented in the CI5 databases. Age-specific incidence rates of liver cancer (based on 5 year age groups ie 5-9 year, 10-14 year and 15-19 years) were calculated using age and sex-disaggregated incidence and population data from the SEER cancer registries. Stata software version 14.0 (StataCorp, USA) was used to calculate age-specific incidence rates, using number of liver cancer incident cases in each age group by the number of population in the respective age group. Age-specific rates were analyzed by period of diagnosis and by birth year. Rate ratios were estimated from age-group-specific Poisson regressions. Results: A total of 140 liver cancer incident cases were registered in the 9 SEER registries between 1978 to 2007 in the US. The incidence rate of liver cancer in children 5 to 9 years of age from 1978-1982 was 0.10 per 100,000 children. The incidence increased to 0.16 for the period from 2003-2007. The same trend is seen for the age group 10-14 and 15-19 years of age. Overall, age-specific incidence rates for liver cancer increased across age groups of 5-9, 10-14 and 15-19 year in the population covered by the 9 SEER registries in the US. However, risk estimates (incidence rate ratios, resulted from age-group-specific Poisson regressions did not show statistical significant effects. Conclusion: While the global response to implement population-wide HBV vaccination program is out of question, efforts to establish processes to evaluate the effect of such programs seems to be incomparably limited. Estimating the effect of HBV vaccination will relatively improve with time as further incidence data become available eg upon publication of data from new volume of CI5 databases.

Secular trends in liver cancer incidence from 1997 to 2014 in Taiwan and projection to 2035: An age-period-cohort analysis.

Liver cancer is the second most common cancer in Taiwan. Research on projected cancer incident rates can facilitate appropriate public health planning, and incidence rate studies can offer insights and enable hypotheses about the etiology of particular cancers. Age-period-cohort models are used to estimate incidence trends in liver cancer from 1997 to 2014 and project trends up to 2035. For men, the age-adjusted incidence rate showed an increasing trend from 1997, which peaked in 2004 (157.6 cases per 100,000 population), and a decreasing trend thereafter. The age-adjusted incidence rate is projected to decrease by 22.2% from 2014 to 2025 and by 37.3% from 2014 to 2035. For women, the age-adjusted incidence rate also showed an increasing trend from 1997, which peaked in 2004 (63.4 cases per 100,000 population), and a decreasing trend thereafter. The age-adjusted incidence rate is projected to decrease by 17.5% from 2014 to 2025 and by 27% from 2014 to 2035. This study revealed a reduction in the incidence rate of liver cancer for both sexes after 2004, and a further decrease until 2035 is projected.

Incidence and Trend of Liver Cancer in Iran.

To determine incidence and trend of the liver cancer in Iran. An observational study. The Cancer Registry System in Iran, from 2003 to 2009. Crude incidence rate for liver cancer were calculated per 100,000 people. Age standardized incidence rates (ASRs) were estimated using direct standardization and the standard population of World Health Organization (WHO). Data was analyzed using Cochran-Armitage test for linear trend and software of WinPepi 2.1. Of 3,584 cases of liver cancer recorded between 2003 and 2009, 2,224 and 1,360 cases were men and women, respectively, which revealed significantly increasing trends (p=0.001). The highest incidence rate (950 cases) occurred in 2007 and the lowest rate (256 cases) in 2003. Based on the result, liver cancer incidence was more in men compared to women and the incidence increased with age. According to this study, the trend of age-standardized incidence rate of liver cancer in Iran is rising. Hence to prevent and control this cancer, it is necessary to investigate the related risk factors and implement prevention programs in Iran.

Trends of liver cancer and its major risk factors in Korea.

The Republic of Korea (hereafter Korea) is one of the countries with high incidence of liver cancer and there is great difference in incidence of liver cancer between male and female. We investigated the sex-specific trends of three major risk factors of liver cancer, which are hepatitis B virus(HBV) infection, hepatitis C virus(HCV) infection, and alcoholic liver cirrhosis. The incidence of liver cancer was obtained from the Cancer Registration Statistics of the National Cancer Center of Korea. Hepatitis B surface antigen (HBsAg) seropositivity was based on data from the 2011 Korea National Health and Nutrition Examination Survey. Disease statistics from the Health Insurance Review and Assessment Service of Korea were used to evaluate trends in HCV infection and alcoholic liver cirrhosis. The prevalence of these risk factors were compared with the incidence of liver cancer. Males had a three to four times higher incidence of liver cancer than females did from 1999 to 2011. This gap between the incidence for males and females increased with age and males aged 50 to 59 showed a five times higher incidence than females of the same age did. In general, HBsAg seropositivity decreased from 1998 to 2011. The prevalence of HCV infections was 96.2 and 90.3 per 100,000 females and males, respectively in 2013. The prevalences of HCV infections from 2009 to 2013 did not substantially differ. The annual average prevalence of alcoholic liver cirrhosis from 2009 to 2013 was 77.22 and 8.90 per 100,000 males and females, respectively; the prevalence among males was 8.7 times higher than that among females. The prevalence rapidly increased with age in males, and males aged 60 to 69 peaked with a 19.2 times higher prevalence than that among females of the same age group. We found that the incidence of alcoholic liver cirrhosis, a major risk factor of liver cancer, exhibited a trend similar to that of liver cancer incidence in males, and this trend also differed remarkably by sex.

Canadian Trends in Liver Cancer: A Brief Clinical and Epidemiologic Overview

Although primary liver cancer is rare, its incidence rate has been rising quickly in Canada, more than tripling since the early 1980s. This cancer is more common in men than women, and the age-specific incidence rates in men have been increasing significantly in all age groups from 40 years of age onward. The death rate has followed a similar upward trajectory, in part because of the low 5-year survival rate of 18% in both sexes. Infection with the hepatitis B or C virus continues to be the most common risk factor, but other factors may also play a role. Risk reduction strategies, such as viral hepatitis screening, have been recommended in other countries and warrant consideration in Canada as part of a coordinated strategy of disease prevention and control.