ReviewLiver cancer epidemic in China: Past, present and future
Introduction
Primary liver cancer (or hepatocellular carcinoma, HCC) is the sixth most common cancer worldwide in terms of numbers of cases of 626,000, and the third most common cause of death from cancer (598,000 deaths annually) [1]. Since over 80% of deaths are in developing countries, liver cancer has been a major public health problem in these parts of the world. China is the area of the world most affected by liver cancer, with an age-standardized incidence rate of 37.9 per 100,000 for men, and of 14.2 per 100,000 [1]. In China nowadays, liver cancer is the second major cause of cancer deaths, with a mortality rate of 26.26 per 100,000 (males: 37.55 and females: 14.45 per 100,000), accounting for 19.33% of all sites of cancers. Accordingly, the estimated annual incident cases and deaths of liver cancer are 360,000 and 350,000, respectively [2]. This article will review the mortality rates, and incidence rates of liver cancer based on the data acquired during the past four decades, and discuss the possible trends and key preventive strategies of this disease in China.
Section snippets
Cancer registration
There was no nationwide cancer registration report system in China a decade before 2000, although a few cancer registries such as Shanghai, Tianjin and Qidong published their cancer registration data in Cancer Incidence in Five Continents (CI5) in the 1990s [3], [4]. Cancer incidence/mortality rates by site from some of China's cancer registries have been published elsewhere [5], [24], [81]. After the year 2002, about 50 cancer registries in China, covering 73 million people (5.7% of the total
Crude mortality rate and age-standardized rate
According to 158 samples available from the survey of death causes for the periods of 2004–2005 in the third survey in China, the crude rate (CR) of liver cancer was 26.26 per 100,000, being 19.33% (37,465/193,841) of all deaths due to cancer. The age-standardized rate by China's population (ASRc) of 1982 was 17.86 per 100,000, and the age-standardized rate by the world population (ASRw) of 1985 was 23.48 per 100,000. The CR, ASRc, and ASRw were 37.55, 26.44, and 34.61 per 100,000, for men, and
The first nationwide retrospective survey for the period of 1973–1975
The mortality rates of liver cancer were 12.5 per 100,000, and 17.6 and 7.3 per 100,000 for males and females in this period. The ASRc and ASRw were 14.52 and 19.96 per 100,000 for men, and 5.61 and 8.07 per 100,000 for women, respectively. In this survey, for the first time, the geographical patterns of liver cancer were investigated and it was found that the mortality rate of liver cancer was higher in the southeast coastal areas than inland, and even higher at the mouth of the Yangtze river
Incidence monitoring throughout cancer registration
Since 2004, the National Central Cancer Registry has set up a mechanism for cancer annual registration. For the first time, it published the China Cancer Registration Annual Report (CCRAR) 2004 [27], and CCRAR 2005 in 2008 [28], covering 45 cancer registries, of which 34 of them were enrolled into the analysis. These data formed the registration-based source of cancer epidemic in China, which provided another estimation of mortality and incidence of liver cancer. These two years’ results are
Conflicts of interest
The authors declare that there are no conflicts of interest.
References (86)
- et al.
Cancer incidence and mortality in Iran
Ann Oncol
(2009) - et al.
Hepatocellular carcinoma and hepatitis B virus. A prospective study of 22 707 men in Taiwan
Lancet
(1981) - et al.
Hepatocellular carcinoma: epidemiology and molecular carcinogenesis
Gastroenterology
(2007) - et al.
Dominant role of hepatitis B virus and cofactor role of aflatoxin in hepatocarcinogenesis in Qidong, China
Hepatology
(2002) World Health Organization cancer priorities in developing countries
Ann Oncol
(2006)- et al.
Global cancer statistics, 2002
CA Cancer J Clin
(2005) - et al.
Analysis of liver cancer mortality in the national retrospective sampling survey of death causes in China 2004–2005
Chin J Prev Med
(2010) - et al.(1992)
- et al.(1997)
Cancer registration in China
APJ CP
(2001)
Statistics on cancer in China: cancer registration in 2002
Eur J Cancer Prev
Survey of cancer mortality in China 1990–1992
Atlas of cancer mortality in the People's Republic of China
A thirty-one year prospective follow-up program on the HBsAg carrier state and primary liver cancer in Qidong, China
Chin J Epidemiol
Cancer incidence in Asian migrants to New South Wales, Australia
Br J Cancer
Cancer epidemiology and control in Taiwan: a brief review
Jpn J Clin Oncol
A cross-border comparison of hepatitis B testing among Chinese residing in Canada and the United States
Asian Pac J Cancer Prev
Cancer mortality in ethnic South Asian migrants in England and Wales (1993–2003): patterns in the overall population and in first and subsequent generations
Br J Cancer
Asian subgroups and cancer incidence and mortality rates in California
Cancer
Cancer incidence, mortality, and associated risk factors among Asian Americans of Chinese, Filipino, Vietnamese, Korean, and Japanese ethnicities
CA Cancer J Clin
Cancer incidence and mortality patterns among specific Asian and Pacific Islander population in the U.S.
Cancer Causes Control
Mortality of primary liver cancer in China from 1990 through 1992
Chin J Oncol
The trend of cancer incidence in urban Beijing from 1982 to 1997
Bull Chin Cancer
Primary liver cancer in Guangxi
Trends in the incidence of cancer in Qidong, China, 1978–2002
Int J Cancer
Cancer incidence and mortality in Guangzhou City from 2000 to 2002
Chin J Cancer
Mortality of hepatoma and cirrhosis of liver in Taiwan
Br J Cancer
Chinese cancer registry annual report: cancer incidence and mortality in Chinese cancer registration areas in 2004
Chinese cancer registry annual report: cancer incidence and mortality in Chinese cancer registration areas in 2005
Chinese cancer registry annual report: cancer incidence and mortality in Chinese cancer registration areas in 2006
Cancer statistics
CA Cancer J Clin
Cancer statistics, trends, and multiple primary cancer analyses from the Surveillance, Epidemiology, and End Results (SEER) Program
Oncologist
Global patterns of cancer incidence and mortality rates and trends
Cancer Epidemiol Biomarkers Prev
The global burden of cancer: priorities for prevention
Carcinogenesis
Preventing primary liver cancer: how well are we faring towards a national hepatitis B strategy?
Med J Aust
Cancer mortality in the United Kingdom: projections to the year 2025
Br J Cancer
The burden of liver cancer in Asians and Pacific Islanders in the Greater San Francisco Bay Area, 1990 through 2004
Cancer
Epidemiological analysis of primary liver cancer in the early 21st century in Guangxi province of China
Chin J Cancer
An analysis of trend on incidence of liver cancer in Fusui Guangxi 1974–2003
Chin Cancer
Evaluation of the secular trend of the mortality of liver cancer in urban of Dalian, 1991–2005
Prev Med Trib
Cited by (229)
Exposure to neonicotinoid insecticides and their characteristic metabolites: Association with human liver cancer
2022, Environmental ResearchCitation Excerpt :Cancer is a multifactorial disease attributed by radiation, lifestyle, smoking, viruses, and environmental pollutants (i.e., pesticides) (Hazarika and Hazarika, 2013). Liver cancer ranks the sixth of most diagnosed cancer and the second most common malignancy (Chen and Zhang, 2011; Fu and Wang, 2018). Pesticide exposure was regarded as a critical environmental risk factor associated with liver cancer development (de Brito Sa Stoppelli and Crestana, 2005; Jaga and Dharmani, 2005; Parrón et al., 2014).
Bufalin enhances the killing efficacy of NK cells against hepatocellular carcinoma by inhibiting MICA shedding
2021, International ImmunopharmacologyEffect of Semaglutide on High-Fat-Diet-Induced Liver Cancer in Obese Mice
2024, Journal of Proteome Research