West J, Wood H, Logan R F A, Quinn M, Aithal G P
Division of Epidemiology and Public Health, University of Nottingham Medical School, Queen's Medical Centre University Hospital, Nottingham NG7 2UH, UK.
Br J Cancer. 2006 Jun 5;94(11):1751-8. doi: 10.1038/sj.bjc.6603127.
In the last two decades, mortality from primary liver cancer has increased in the UK. We aimed to determine whether the incidence trends for these cancers were similar and in particular if the increasing occurrence of cholangiocarcinoma has continued. We calculated directly age-standardised incidence rates (using the European standard population) by subsite and histological type for all cancers of the liver, gallbladder and biliary tract in England and Wales from 1971 to 2001, using cancer registry data. The incidence of cancers of the liver, gallbladder and biliary tract increased, with the greatest rise, around 12-fold, in intrahepatic bile duct cancers. The rate of liver cell cancer increased by around 45% in males, but by <10% in females. There were marked reductions in the incidence of gallbladder and extrahepatic bile duct cancer. Cholangiocarcinoma increased around 16-fold and became the most common type of primary liver cancer in females, while hepatocellular carcinoma remained the commonest type in males. The age-specific incidence rates showed that intrahepatic bile duct cancer continued to increase throughout the 1990s in those aged 75 and over, while liver cell cancer decreased in the older age groups. In conclusion, there were increases in the incidence of primary liver cancer, which have been particularly dramatic for intrahepatic bile duct cancer, over the last three decades of the 20th century in England and Wales. There has been a halving in the incidence of gallbladder cancer and a reduction of a third in extrahepatic bile duct cancer.
在过去二十年中,英国原发性肝癌的死亡率有所上升。我们旨在确定这些癌症的发病率趋势是否相似,特别是胆管癌发病率的持续上升情况是否依然存在。我们利用癌症登记数据,计算了1971年至2001年英格兰和威尔士所有肝癌、胆囊癌和胆管癌按亚部位和组织学类型直接标准化的发病率(采用欧洲标准人口)。肝癌、胆囊癌和胆管癌的发病率均有所上升,其中肝内胆管癌上升幅度最大,约为12倍。男性肝细胞癌发病率上升约45%,而女性上升幅度小于10%。胆囊癌和肝外胆管癌的发病率显著下降。胆管癌发病率上升约16倍,成为女性最常见的原发性肝癌类型,而肝细胞癌仍是男性最常见的类型。年龄别发病率显示,在75岁及以上人群中,肝内胆管癌在整个20世纪90年代持续上升,而老年组的肝细胞癌发病率则有所下降。总之,在20世纪最后三十年里,英格兰和威尔士原发性肝癌的发病率有所上升,其中肝内胆管癌的上升尤为显著。胆囊癌发病率减半,肝外胆管癌发病率降低三分之一。