Islami Farhad, Dikshit Rajesh, Mallath Mohandas K, Jemal Ahmedin
Surveillance and Health Services Research, American Cancer Society, Atlanta, United States.
Department of Epidemiology, Tata Memorial Hospital, Parel, Mumbai, India.
Cancer Epidemiol. 2016 Feb;40:79-86. doi: 10.1016/j.canep.2015.11.012. Epub 2015 Dec 9.
More than 25,000 people die of liver cancer annually in India. There is little information about the contribution of hepatitis B virus (HBV) and hepatitis C virus (HCV) to these deaths. We conducted a systematic review of published studies on HBV or HCV infection and liver cancer in India and estimated the population attributable fraction (PAF) of liver cancer deaths caused by these infections and the corresponding annual number of deaths and years of life lost (YLL) in the country.
We searched the PubMed and Scopus databases, as well as the reference list of relevant articles in the systematic review. For calculation of the number of liver cancer deaths attributable to HBV and HCV, we used two sources of outcome data and two relative risks for the association between HCV and liver cancer.
The PAF was 67% for HBV, 17-19% for HCV, and 71-72% for HBV and/or HCV. The annual attributable number of liver cancer deaths was approximately 17,000 for HBV; 4500 for HCV; and 18,500 for HBV and/or HCV, corresponding to approximately 297,000, 75,000, and 315,000 YLL, respectively. There was little difference in these numbers using the two sources of outcome data or the two risk estimates for HCV.
Our findings underscore the importance of primary prevention of HBV and HCV by appropriate measures, including vaccination (HBV only), prevention of transfusion-related infections, and increased awareness of the routes of transmission and long-term health outcomes.
在印度，每年有超过2.5万人死于肝癌。关于乙型肝炎病毒（HBV）和丙型肝炎病毒（HCV）对这些死亡的贡献，相关信息较少。我们对印度已发表的关于HBV或HCV感染与肝癌的研究进行了系统综述，并估计了由这些感染导致的肝癌死亡的人群归因分数（PAF）以及该国相应的年度死亡人数和寿命损失年数（YLL）。
我们检索了PubMed和Scopus数据库，以及系统综述中相关文章的参考文献列表。为了计算可归因于HBV和HCV的肝癌死亡人数，我们使用了两种结局数据来源以及两种HCV与肝癌关联的相对风险。
HBV的PAF为67%，HCV为17 - 19%，HBV和/或HCV为71 - 72%。HBV导致的肝癌年度归因死亡人数约为17,000人；HCV为4500人；HBV和/或HCV为18,500人，分别对应约297,000、75,000和3,15,000个YLL。使用两种结局数据来源或两种HCV风险估计得出的这些数字差异不大。
我们的研究结果强调了通过适当措施进行HBV和HCV一级预防的重要性，这些措施包括接种疫苗（仅针对HBV）、预防输血相关感染以及提高对传播途径和长期健康结局的认识。
