Department of Epidemiology, Infectious Disease Control and Prevention, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima.
Hepatol Res. 2014 Jul;44(7):713-9. doi: 10.1111/hepr.12177. Epub 2013 Jul 11.
We aimed to simulate the mortality due to hepatocellular carcinoma (HCC) by the age-period-cohort (APC) model with use of sex- and age-specific mortality data, for the purpose of validating the utility and assessing the limitation of this model.
Age-specific mortality due to HCC was gleaned from people aged 20-84 years during 1940 through 2010 in Japan.
The APC model had a high performance in reproducing HCC mortality (modified determination coefficient R(2) COR ≥ 0.99). Risk of HCC increased with age in both sexes, while risk of period barely changed in both sexes. The birth cohort factor in the APC model in males highlighted the maximum point within birth years 1931-1935. The observed HCC mortality in 2010 in males (19 444) was lower than the predicted, and corresponded to 72.3% of the predicted 26 883.4, and in all age groups by 5-year increments (55.6-90.9%). In females, the observed mortality was lower than that predicted in those aged 64 years or less, but not in those aged 65 years or more.
We applied the APC model to predict HCC mortality rate, and it reproduced the observed mortality rate faithfully. However, in the recent past, the observed morality rate in males was only 72.3% that of the predicted. Such differences would be attributed to combined effects of medical interventions, such as antiviral treatments and screening for hepatitis viruses implemented in the early 1990s in Japan.
本研究旨在通过年龄-时期-队列（APC）模型模拟肝癌（HCC）死亡率，使用特定性别和年龄的死亡率数据，以验证该模型的实用性并评估其局限性。
从日本 1940 年至 2010 年期间年龄在 20-84 岁的人群中获取特定性别和年龄的 HCC 死亡率数据。
APC 模型在重现 HCC 死亡率方面表现出色（修正决定系数 R²COR≥0.99）。男女 HCC 风险均随年龄增长而增加，而时期风险在两性中几乎不变。APC 模型中的男性队列因素突出了 1931-1935 年出生年份的最高点。2010 年男性 HCC 实际死亡率（19444 例）低于预测值，为预测值 26883.4 的 72.3%，且各年龄组均降低（55.6-90.9%）。在女性中，64 岁及以下年龄组的观察死亡率低于预测值，但 65 岁及以上年龄组则不然。
我们应用 APC 模型预测 HCC 死亡率，该模型能够准确地再现观察到的死亡率。然而，在最近的过去，男性的实际死亡率仅为预测值的 72.3%。这种差异可能归因于 20 世纪 90 年代初在日本实施的抗病毒治疗和肝炎病毒筛查等医疗干预措施的综合影响。
