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Researchers update HCC mortality global trends, assess 2020 prediction

Researchers reviewed the WHO database from 1990 to 2014 to update global trends of hepatocellular mortality and predict trends in rates in Europe, the United States and Japan, according to a recently published study.

“HCC is one of the few major cancer sites showing unfavorable trends in several areas of the world over the last few decades, including the EU, North and Latin America,” the researchers wrote. “Only areas with very high rates in the past, including Japan, Korea and China, showed appreciable declines in rates. Still, over the most recent years, HCC mortality was two- to five-fold higher in Japan, Hong Kong or Korea than in most European countries and the Americas. Steady declines to 2020 are predicted for East Asia but not for Europe and the Americas.”

In men of all ages in Europe and the EU, HCC mortality rates declined from 2002 to 2012 in the Czech Republic (–19.2%), Spain (–14.7%), France (–14%), Italy (–11.8%), Serbia (–12.4%) and Switzerland (–6.7%). Mortality rates increased substantially in Denmark (100.7%), the United Kingdom (67.9%), Romania (64.3%), Portugal (63.6%) and Norway (22%).

In Asia, rates for men declined in Japan (–42.1%), the Republic of Korea (–23.7%) and Hong Kong (–23.7%); however, the authors still considered the rates to be “extremely high” in 2012 (10.2, 23.7 and 12.1 per 100,000, respectively). In the United States, the rate for men increased to 34.8%, but was relatively low in 2002 (2.3-3.1 per 100,000).

Overall female mortality rates declined from 2002 to 2012 in Spain (–39.2%), the Czech Republic (–29.3%), Italy (–25.6%) and Norway (–37.2%), while rates increased in Denmark (97.6%), Romania (47.5%) and the United Kingdom (57.1%). In Asia, rates declined in Japan (–41%), the Republic of Korea (–29%) and Hong Kong (–11), but had higher rates compared with Europe and the Americas (6.1, 3 and 2.6 per 100,000, respectively).

Mortality rates were more favorable in younger patients (20-44 years) than in middle-aged patients (45-59 years). Trends for the younger group decreased in the United States (–30.3%), Australia (–30.6%), Germany (–10.5%) and the United Kingdom (–13%), whereas trends increased for the middle-aged group in the EU (11.1%), the United States (27.9%) and Australia (86.6%).

The researchers predicted that in 2020, per 100,000 men or women, the rates will be 5.4 in men and 1.2 in women in Japan, 3.9 in men and 0.8 in women in the EU, and 3 in men and 0.7 in women in the United States.

“Despite the appreciably higher relative risks for [hepatitis B] and [hepatitis C] than for other factors,” such as heavy alcohol intake, tobacco smoking and aflatoxin, “population attributable risks of HCC vary across different areas of the world according to the prevalence of risk factors. Thus, HBV is the key determinant of HCC in eastern Asia, except Japan, it is HCV in Japan and southern Europe, and diabetes and obesity in North America,” the researchers concluded. “However, mortality is declining in young generations, reflecting the impact of HBV vaccination and improved treatment of HCV. Thus, global future trends in HCC are likely to become more favorable than those registered over the last few decades, particularly in high mortality areas of the world.” – by Talitha Bennett

Disclosure: The researchers report no relevant financial disclosures.