Menzies Institute for Medical Research, University of Tasmania.
Royal Hobart Hospital, Hobart, Tasmania.
Aust N Z J Public Health. 2019 Jun;43(3):267-273. doi: 10.1111/1753-6405.12889. Epub 2019 Apr 8.
Assess national and jurisdictional incidence and mortality trends for primary liver cancer in Australia.
Analysis of Australian Cancer Incidence and Mortality data published in 2017 by the AIHW. Age-standardised rates (ASR) for 1982 to 2014/2015. Piecewise linear regression was used to assess temporal trends. For the purposes of comparison, data were also extracted for all cancers with greater burdens of disease (lung, colorectal, breast, prostate, pancreatic, and brain cancers and melanoma of the skin).
Since 1982, the average annual percentage change (AAPC) for ASR incidence of liver cancer was 4.858% (95%CI 4.558-5.563). This marked a 306% increase from 1.822/100,000 persons (95%CI 1.586-2.058) in 1982 to 7.396/100,000 persons (95%CI 7.069-7.723) in 2014. AAPC for ASR mortality was 3.013% (95%CI 2.448-3.521): an increase of 184% from 2.323/100,000 persons (95%CI 2.052-2.594) in 1982 to 6.593/100,000 (95%CI 6.290-6.896) in 2015. ASR incidence and mortality were highest in the NT (12.607/100,000 persons), VIC (8.229/100,000) and NSW (7.798/100,000). In comparison to the other selected cancers, higher AAPC for both incidence and mortality of liver cancer were observed.
Incidence and mortality associated with liver cancer have increased substantially in the past three decades, in contrast to the improved outcomes observed for many other cancers. Jurisdictional incidence rates reflect higher prevalence of hepatitis B and C. Implications for public health: In the context of Australian cancer prevention and care programs, liver cancer is an outlier. Strategies to mitigate risk factors and improve surveillance of liver health for at-risk groups are urgently required.
评估澳大利亚原发性肝癌的国家和地区发病率和死亡率趋势。
分析澳大利亚癌症发病率和死亡率数据，由澳大利亚卫生与福利研究所于 2017 年出版。1982 年至 2014/2015 年的年龄标准化率（ASR）。采用分段线性回归评估时间趋势。为了进行比较，还提取了所有疾病负担更大的癌症（肺癌、结直肠癌、乳腺癌、前列腺癌、胰腺癌和脑癌以及皮肤黑色素瘤）的数据。
自 1982 年以来，肝癌发病率的年均百分比变化（AAPC）为 4.858%（95%CI 4.558-5.563）。这标志着发病率从 1982 年的 1.822/100,000 人（95%CI 1.586-2.058）增加到 2014 年的 7.396/100,000 人（95%CI 7.069-7.723），增长了 306%。ASR 死亡率的 AAPC 为 3.013%（95%CI 2.448-3.521）：从 1982 年的 2.323/100,000 人（95%CI 2.052-2.594）增加到 2015 年的 6.593/100,000（95%CI 6.290-6.896），增长了 184%。ASR 发病率和死亡率在北领地（12.607/100,000 人）、维多利亚州（8.229/100,000 人）和新南威尔士州（7.798/100,000 人）最高。与其他选定的癌症相比，肝癌的发病率和死亡率都有较高的 AAPC。
在过去三十年中，肝癌的发病率和死亡率大幅上升，而许多其他癌症的预后有所改善。地区发病率反映了乙型肝炎和丙型肝炎的更高患病率。对公共卫生的影响：在澳大利亚癌症预防和护理计划的背景下，肝癌是一个例外。迫切需要制定战略来减轻风险因素并改善高危人群的肝脏健康监测。
