|Title:||Age-Period-Cohort Analysis of Hepatocellular Carcinoma Mortality in Taiwan, 1976-2005||Authors:||Lee L.-T.
|Issue Date:||2009||Journal Volume:||19||Journal Issue:||5||Start page/Pages:||323-328||Source:||Annals of Epidemiology||Abstract:||
Purpose: Hepatocellular carcinoma (HCC) is one of the most common malignant primary liver tumors worldwide. A previous study showed a decline in pediatric HCC in Taiwan after the universal vaccination program was initiated in 1984. We investigated whether the recent change in HCC mortality in Taiwan represented a short-term fluctuation or an emerging long-term decline trend. Methods: An age-period-cohort analysis was conducted to show HCC mortality trends between 1976 and 2005. A total of 121,643 HCC mortality cases (92,926 males and 28,717 females) of individuals older than 40 years of age was used in the analyses. Results: Results indicate an increasing secular trend in HCC mortality over the last three decades in people aged 60 years and above. In the age group of >85 years old, the mortality rate for males and females was 7.47 (95% confidence interval [95% CI]: 6.24-8.94) and 25.0 (95% CI: 15.5-40.2) times greater than in the youngest age group (40-44), respectively. The relative risk of dying from HCC in the period 2001-2005 was 1.36 (95% CI: 1.23-1.50) for males compared to the 1976-1980 time period, and 1.42 (95% CI: 1.17-1.72) for females compared to the 1986-1990 time period. A strong birth-cohort effect was also found. Individuals born around 1936 had the highest risk of dying from HCC. Conclusion: These findings imply that important determinants of HCC may occur early in life, with their effects only becoming apparent much later. ? 2009 Elsevier Inc. All rights reserved.
|ISSN:||1047-2797||DOI:||10.1016/j.annepidem.2008.12.013||SDG/Keyword:||adult; aged; article; cancer mortality; controlled study; female; groups by age; human; liver cell carcinoma; major clinical study; male; priority journal; sex difference; Taiwan; Adult; Age Factors; Aged; Aged, 80 and over; Carcinoma, Hepatocellular; Cohort Studies; Female; Hepatitis B Vaccines; Humans; Liver Neoplasms; Male; Middle Aged; Mortality; Sex Factors; Taiwan
|Appears in Collections:||流行病學與預防醫學研究所|
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