Long-Term Trend of Liver Cancer Mortality in Serbia, 1991-2015: An Age-Period-Cohort and Joinpoint Regression Analysis.

Trends of liver cancer mortality vary widely around the world. The purpose of this study was to assess the trend of liver cancer mortality in Serbia. Descriptive epidemiological study design was used in this research. The age-standardized rates (ASRs, per 100,000) were calculated using the direct method, according to the World standard population. Temporal trends were assessed using the average annual percent change (AAPC) with 95% confidence interval (95% CI), according to joinpoint regression. An age-period-cohort analysis was used to evaluate the underlying factors for liver cancer mortality trends. In Serbia from 1991 to 2015, over 11,000 men and nearly 8000 women died from liver cancer. The trend in liver cancer mortality significantly decreased both in men (AAPC = -1.3%; 95% CI = -1.7 to -0.9) and women (AAPC = -1.5%; 95% CI = -1.9 to -1.1). For liver cancer mortality, statistically significant cohort and period effects were observed in both genders. The downward trends in liver cancer mortality in Serbia are recorded during the past decades.