Causes of increased mortality from hepatocellular carcinoma in high incidence country: Taiwan experience
Journal
Journal of Gastroenterology and Hepatology (Australia)
Journal Volume
20
Journal Issue
4
Pages
521-526
Date Issued
2005
Author(s)
Abstract
Background: Since 1991, a rapid rise in mortality from hepatocellular carcinoma (HCC) has been observed in Taiwan in subjects aged ?20 years. The aim of the present study was to assess whether poor survival or excess incident cases pertaining to a cohort effect or a time-period effect accounted for such a rise. Methods: A total of 41 150 deaths and 51 201 incident HCC patients (International Classification of Diseases = 155.0) aged 20-79 years between 1985 and 1998 were studied. Trends in HCC mortality rates were divided into two groups: annual case-fatality rates and HCC incidence rates by age. Poisson regression was used to distinguish a cohort effect from a time-period effect on the incidence of HCC. Results: Subjects aged >50 years after 1991 had the greatest risk of death (relative risk [RR] = 11.3; 95% confidence interval [CI]: 11.0-11.7). Annual case-fatality rates declined from 1.6 in 1985 to 0.84 in 1998, whereas there was a remarkable increase in incidence, particularly from 1991 onward, in the >50-year-olds. It was found that subjects aged >50 years who were born before 1944 were the group most susceptible to HCC (RR= 9.3; 95%CI: 9.1-9.5). Conclusion: Increased incidence, particularly in individuals over 50, rather than poor survival, accounts for the rapid rise in mortality from HCC. ? 2004 Blackwell Publishing Asia Pty Ltd.
Subjects
Case-fatality rate; Cohort effect; Hepatocellular carcinoma; Incidence; Mortality
SDGs
Other Subjects
adult; age distribution; aged; article; cancer classification; cancer incidence; cancer mortality; cancer survival; cohort analysis; disease activity; disease course; disease severity; female; human; liver cell carcinoma; major clinical study; male; Poisson distribution; priority journal; Taiwan
Publisher
Blackwell Publishing
Type
journal article