Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD.
Slone Epidemiology Center, Boston University, Boston, MA.
Int J Cancer. 2020 Jul 15;147(2):317-330. doi: 10.1002/ijc.32723. Epub 2019 Nov 5.
Primary liver cancer, the major histology of which is hepatocellular carcinoma (HCC), is the second leading cause of cancer death worldwide. We comprehensively examined recent international trends of primary liver cancer and HCC incidence using population-based cancer registry data. Incidence for all primary liver cancer and for HCC by calendar time and birth cohort was examined for selected countries between 1978 and 2012. For each successive 5-year period, age-standardized incidence rates were calculated from Volumes V to XI of the Cancer Incidence in Five Continents (CI5) series using the online electronic databases, CI5plus. Large variations persist in liver cancer incidence globally. Rates of liver cancer remain highest in Asian countries, specifically in the East and South-East, and Italy. However, rates in these high-risk countries have been decreasing in recent years. Rates in India and in most countries of Europe, the Americas and Oceania are rising. As the population seroprevalence of hepatitis B virus (HBV) continues to decline, we anticipate rates of HCC in many high-risk countries will continue to decrease. Treatment of hepatitis C virus (HCV) is likely to bring down rates further in some high-rate, as well as low-rate, countries with access to effective therapies. However, such gains in the control of liver cancer are at risk of being reversed by the growing obesity and diabetes epidemics, suggesting diabetes treatment and primary prevention of obesity will be key in reducing liver cancer in the longer-term.
原发性肝癌，其主要组织学类型为肝细胞癌（HCC），是全球癌症死亡的第二大主要原因。我们综合考察了基于人群的癌症登记数据中，原发性肝癌和 HCC 发病率的国际最新趋势。在 1978 年至 2012 年期间，我们对选定国家的所有原发性肝癌和 HCC 的按时间和出生队列划分的发病率进行了考察。对于每个连续的 5 年时间段，我们使用在线电子数据库 CI5plus，从《五大洲癌症发病率》（CI5）系列的第五卷到第十一卷计算了年龄标准化发病率。全球范围内肝癌发病率仍存在较大差异。肝癌发病率在亚洲国家最高，特别是在东亚和东南亚以及意大利。然而，近年来这些高风险国家的发病率一直在下降。印度和大多数欧洲、美洲和大洋洲国家的发病率正在上升。随着乙型肝炎病毒（HBV）的人群血清阳性率继续下降，我们预计许多高风险国家的 HCC 发病率将继续下降。在一些高发病率和低发病率的国家，获得有效治疗方法的情况下，丙型肝炎病毒（HCV）的治疗可能会进一步降低发病率。然而，肥胖症和糖尿病的流行日益加剧，这些在肝癌控制方面的进展可能会面临风险，这表明糖尿病治疗和肥胖症的一级预防将是长期内降低肝癌发病率的关键。
