Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.
Laboratory of Clinical Analysis of Navarra Hospital, Pamplona, Spain.
J Hepatol. 2017 Aug;67(2):302-309. doi: 10.1016/j.jhep.2017.03.011. Epub 2017 Mar 21.
BACKGROUND & AIMS: Trends in hepatocellular carcinoma (HCC) mortality rates have increased over recent decades in most countries. It is also the third cause of cancer death worldwide. The aim of this study is to update global trends in HCC mortality to 2014, and predict trends in rates in the EU, USA and Japan to 2020.
Death certification data for HCC over the 1990-2014 period from the World Health Organization database were analyzed. Sixteen European, five American countries, and six other countries worldwide were included, as well as the EU as a whole.
In European men, mortality rates were stable during the last decade (3.5/100,000). HCC mortality increased in Northern and Central Europe, and decreased in Southern Europe. In the USA, HCC mortality increased by 35% between 2002 and 2012, reaching 3.1/100,000 men in 2012; it is predicted to remain stable to 2020. Reduced mortality rates were observed in East Asia, although they remained around 10-24/100,000 men. In Japan, HCC mortality is predicted to decrease (5.4/100,000 men in 2020). Trends were favorable in the young, but unfavorable in middle aged, except in East Asia. Mortality rates were 3- to 5-fold lower in women than men in most regions, but trends were similar.
Control of hepatitis B (HBV) and hepatitis C virus (HCV) infections has contributed to the decrease in HCC-related mortality in East Asia and Southern Europe. Unfavorable trends in other regions can be attributed to HCV (and HBV) epidemics in the 1960s and 1980s, alcohol consumption, increased overweight/obesity, and diabetes. Better management of cirrhosis, HCC diagnosis and treatment are also influencing the mortality trends worldwide.
Mortality rates due to HCC have increased in many countries over recent decades. In this study, we updated worldwide mortality trends for HCC from 1990 to 2014, and predicted trends for some countries to 2020. We observed unfavorable trends in Northern and Central Europe, North and Latin America. East Asia showed an improvement, however mortality rates in this region were 2- to 5-fold higher than in most European countries and the Americas. Steady declines to 2020 are predicted for East Asia but not for Europe and the Americas.
近几十年来，大多数国家的肝细胞癌（HCC）死亡率呈上升趋势。它也是全球癌症死亡的第三大原因。本研究的目的是更新全球 HCC 死亡率的最新趋势至 2014 年，并预测 2020 年欧盟、美国和日本的 HCC 死亡率趋势。
对 1990 年至 2014 年期间世界卫生组织数据库中 HCC 的死亡证明数据进行了分析。包括 16 个欧洲国家、5 个美国国家和全球其他 6 个国家，以及整个欧盟。
在欧洲男性中，过去十年中死亡率保持稳定（3.5/100,000）。北欧和中欧的 HCC 死亡率上升，南欧的死亡率下降。在美国，2002 年至 2012 年间 HCC 死亡率上升了 35%，2012 年达到 3.1/100,000 男性；预计到 2020 年将保持稳定。东亚地区的死亡率有所下降，尽管仍保持在每 10-24/100,000 男性。预计日本 HCC 死亡率将下降（2020 年每 100,000 男性 5.4/100,000）。年轻人的趋势较好，但中年人的趋势不佳，东亚除外。在大多数地区，女性的死亡率是男性的 3-5 倍，但趋势相似。
乙型肝炎（HBV）和丙型肝炎病毒（HCV）感染的控制有助于降低东亚和南欧与 HCC 相关的死亡率。其他地区的不利趋势可归因于 20 世纪 60 年代和 80 年代的 HCV（和 HBV）流行、酒精消费、超重/肥胖和糖尿病增加。肝硬化、HCC 诊断和治疗的更好管理也影响着全球死亡率的趋势。
近几十年来，许多国家的 HCC 死亡率有所上升。在这项研究中，我们更新了 1990 年至 2014 年全球 HCC 死亡率的最新趋势，并预测了一些国家到 2020 年的趋势。我们观察到北欧和中欧、北美和拉丁美洲的趋势不利。然而，东亚的情况有所改善，但该地区的死亡率是大多数欧洲国家和美洲的 2-5 倍。预计东亚到 2020 年将稳步下降，但欧洲和美洲不会。
