Hepatocellular carcinoma: Recent trends in Japan

Kiyosawa, Kendo; Umemura, Takeji; Ichijo, Tetsuya; Matsumoto, Akihiro; Yoshizawa, Kaname; Gad, Amal; Tanaka, Eiji

doi:10.1053/j.gastro.2004.09.012

Cited by 277 publications

(242 citation statements)

References 43 publications

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“…As shown here, most non-B-HCCs in Taiwan after 1993 were related to HCV infection and, therefore, the relative decrease B-HCC was most likely caused by an increase in C-HCC. This trend is similar to trends described in countries with low HBV infection rates, such as Japan [20][21][22] and the United States. 23 Available studies indicate that HCV infections acquired 2-4 decades ago explain at least half of the observed increase in HCC in Western countries, and C-HCC is quite likely to continue to increase over the next decade.…”

Section: Discussionsupporting

confidence: 85%

“…The mean age of B-HCC patients was 12 years younger than that of C-HCC patients, which is similar to previous results. 18,21 This difference may be explained by the natural course of chronic HBV or HCV infection; that is, HBV infection is usually acquired perinatally, while HCV infection is acquired in adulthood. The overall male/female ratio in our study was 3.6.…”

Section: Discussionmentioning

confidence: 99%

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Secular trends and geographic variations of hepatitis B virus and hepatitis C virus‐associated hepatocellular carcinoma in Taiwan

Yang

et al. 2006

Intl Journal of Cancer

122

128

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Etiological variations in hepatocellular carcinoma (HCC) exist across different geographic areas. To gain better control of HCC, we retrospectively studied the secular trends and geographic variations in hepatitis B virus (HBV)-related and hepatitis C virus (HCV)-related HCCs in Taiwan. A total of 18,423 HCC cases enrolled in 8 medical centers from 1981 to 2001 were reviewed. Overall, 67% of male HCC in Taiwan was related to HBV infection whereas 55.2% of female HCC in Taiwan was related to HCV infection. The mean age of patients with HBV-related HCC was 53.2 6 13.6 years, while the mean age of patients with HCV-related HCC was 65.1 6 9.1 years (p < 0.001). The male/female ratio was 6.4 for HBV-related HCC, while it was 1.7 for the HCV-related HCC (p < 0.001). The percentage of HBV-related HCC progressively decreased from 81.5 to 66.2% in males, and from 66.7 to 41.4% in females over the study period. Our study demonstrates that the percentage of HBV-related HCC has progressively decreased over the last 20 years. The relative decrease in HBV-related HCC was not due to a decrease in HBV-related HCC death. Instead, it was caused by an increase in HCV-related HCC. Prevention of new HCV infection and the treatment of chronic hepatitis C should be the primary goals, which will result in better control of HCC in the future, even in an HBV-endemic area like Taiwan. ' 2006 Wiley-Liss, Inc.Key words: hepatocellular carcinoma; hepatitis B virus; hepatitis C virus; secular trend; geographic variation; Taiwan Hepatocellular carcinoma (HCC) is one of the most common malignancies in the world, especially in sub-Saharan Africa and Southeast Asia. Since 1984, it has been the leading cause of cancer death in Taiwan, 1 accounting for approximately 7,000 death annually. In addition, around 8,000 new HCC cases are diagnosed each year. 2 High-risk groups for HCC include patients chronically infected with hepatitis B virus (HBV) or hepatitis C virus (HCV), liver cirrhosis patients, and people with a family history of HCC. Chronic HBV and HCV infections are the 2 major etiologies of HCC in Taiwan. 3 About 15-20% of the general population in Taiwan are chronic carriers of hepatitis B surface antigen (HBsAg). 4 HBV carriers have a 20-to 98-fold increased risk of HCC, 5,6 especially among the hepatitis B e antigen (HBeAg)-positive group. 7 A recent prospective study has further confirmed that positivity for HBeAg is associated with an increased risk of HCC. 8 To combat HBV infection in Taiwan, a mass immunization program has been launched on July 1, 1984, aiming first at the prevention of perinatal mother-to-infant, chronic HBV infection. 9 This nationwide vaccination program has markedly decreased the HBV carrier rate 10 and childhood HBVrelated HCCs (B-HCCs). 11 An 80-85% decrease in HCC among Taiwanese adults up to 3-4 decades later is anticipated. 12 The prevalence of anti-HCV antibody (anti-HCV) is 2-4% among the general population of Taiwan, 13 while it ranges from 0.95 to 2.2% in Taiwanese blood donors. 13,14 The anti-HCV prevalen...

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Secular trends and geographic variations of hepatitis B virus and hepatitis C virus‐associated hepatocellular carcinoma in Taiwan

Yang

et al. 2006

Intl Journal of Cancer

122

128

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“…Thus, for the combined cohort, the 3-year incidence of HCC from study entry was 1.9%, increasing to 5.9% at 5 years, yielding an annual incidence of HCC of 1.1%. This figure is consistent with, but at the lower range of, previous estimates of the annual incidence of HCC both in the United States 29 , now increasing 30 , and in Europe 3, 4, 12 but clearly lower than the rates reported among HCV-infected persons in Japan [31][32][33] .…”

Section: Discussionsupporting

confidence: 90%

Incidence of Hepatocellular Carcinoma and Associated Risk Factors in Hepatitis C-Related Advanced Liver Disease

Harnois¹

2009

Yearbook of Gastroenterology

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“…HCC is one of the most common cancers worldwide [1][2][3][4]. Most HCC patients have a chronic liver disease in the background liver, among which chronic viral hepatitis due to hepatitis C virus (HCV) or hepatitis B virus (HBV) is very common [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Ultrasound surveillance for early detection of hepatocellular carcinoma among patients with chronic hepatitis C

et al. 2009

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Background and aims Ultrasonography is the most frequently used modality in surveillance for HCC among patients with chronic hepatitis C. However, the optimal surveillance interval is still controversial and the usefulness of supplementary tumor marker determination has not been confirmed. Methods A total of 243 cases of naive HCC were detected among 1,431 patients with chronic hepatitis C under outpatient-based surveillance. The mode of HCC detection, including ultrasound surveillance interval, was retrospectively examined and the relation between the interval and detected tumor size was analyzed. Tumor volume doubling time was estimated from exponential increase in serum tumor marker levels when applicable. Results HCC was first detected by ultrasonography in 221 patients. Ultrasound surveillance interval, ranging between 2 and 8 months, was not correlated with the size of tumor at detection. Patients with cirrhosis were likely to be surveyed at shorter intervals. The size of tumor exceeded 30 mm only in three (1.4%) cases. They were all positive for a biomarker and the estimated tumor doubling time was short. In 14 cases, HCC was first detected by CT indicated by abnormal rise in tumor marker levels despite negative ultrasound findings. In the remaining eight cases, ultrasonography had been replaced by CT as surveillance modality because of excessive obesity or coarseness of liver parenchyma.Conclusions Ultrasound surveillance at 6-month intervals was appropriate in general for the detection of HCC at a size smaller than 30 mm. However, in patient with established cirrhosis, more frequent screening would be needed to detect tumors of the same size.

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Hepatocellular carcinoma: Recent trends in Japan

Cited by 277 publications

References 43 publications

Secular trends and geographic variations of hepatitis B virus and hepatitis C virus‐associated hepatocellular carcinoma in Taiwan

Secular trends and geographic variations of hepatitis B virus and hepatitis C virus‐associated hepatocellular carcinoma in Taiwan

Incidence of Hepatocellular Carcinoma and Associated Risk Factors in Hepatitis C-Related Advanced Liver Disease

Ultrasound surveillance for early detection of hepatocellular carcinoma among patients with chronic hepatitis C

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