Liver Cancer Mortality and Food Consumption in Serbia, 1991-2010: An Ecological Study

Abstract

SUMMARYAim: This paper investigates the correlation between liver cancer mortality and consumption of food-groups in Serbia. Methods: We conducted an ecological study. The study comprised the population of the Republic of Serbia (about 7.5 million inhabitants) during the period 1991-2010. This ecological study included the data on food consumption per capita which were obtained by the Household Budget Survey and mortality data for liver cancer made available by the National Statistical Office. Linear trend model was used to assess a trend of age-adjusted liver cancer mortality rates (per 100,000 persons) that were calculated by the method of direct standardization using the World Standard Population. Pearson correlation was performed to examine the association between liver cancer mortality and per capita food consumption quantified with a correlation coefficient (r value).Results: In Serbia, over the past two decades a significantly decreasing trend of liver cancer mortality rates has been observed (p < 0.001). Liver cancer mortality was significantly (p < 0.01) positively correlated with animal fat, beef, wine and spirits intake (r = 0.713, 0.631, 0.632 and 0.745, respectively). A weakly positive correlation between milk consumption and mortality from liver cancer (r = 0.559, p < 0.05) was found only among women. The strongest correlation was found between spirits consumption and liver cancer mortality rates in women (r = 0.851, p < 0.01). A negative correlation between coffee consumption and age-adjusted liver cancer mortality rates was found (r = −0.516, p < 0.05) only for the eldest men (aged 65 years or older).Conclusions: Correlations between liver cancer and dietary habits were observed and further effort is needed in order to investigate a possible causative association, using epidemiological analytical studies.

Time trends in liver cancer mortality rates in Montenegro from 1990 to 2018

“…Until mid-1999, mortality in the 50–69 and 70+ age groups tended to increase, then it fell sharply between 2000 and 2005, but it did not change again between 2006 and 2019 [24]. The neighboring country of Serbia [9,28] also shows favorable trends in mortality; over a comparable period from 1991 to 2015, there was a significant decrease of 1% per year for the overall level, 1% for men and 1% for women, with an average rate that was more than 30% higher than in Montenegro.…”

“…Women's liver cancer mortality decreased significantly in the 55-79 age group, but nonsignificant declines were noted in the 45-49 and 50-54 age groups, as well as in the 80-84 age group [28]. Aside from the implementation of the HBV vaccination program and the screening of blood products for HCV and HBV markers [31], other factors contributing to Serbia's favorable mortality trend include increased prevention efforts and changes in the prevalence of risk factors [9,28]. Socioeconomic factors contribute significantly to reducing mortality rates around the world, especially concerning access to health care [32][33][34].…”

“…Some studies show that the consumption of animal fat is significantly positively correlated with mortality from liver cancer. Nevertheless, consumption of vegetables, poultry, fish, eggs and yogurt has been shown to have a protective effect on liver cancer mortality [9].…”

Effect of prior thyroid cancer on survival of primary liver cancer: a study based on the SEER database

“…Cancer patients tend to have good eating habits after being diagnosed, such as reducing alcohol consumption 26 . Previous studies speculated that a history of alcohol consumption may be a potential prognostic factor for liver cancer patients 27 , 28 .…”