Liver cancer mortality over six decades in an epidemic area: what we have learned

Abstract

Background and aims: Liver cancer is one of the most dominant malignant tumors in the world. The trends of liver cancer mortality over the past six decades have been tracked in the epidemic region of Qidong, China. Using epidemiological tools, we explore the dynamic changes in age-standardized rates to characterize important aspects of liver cancer etiology and prevention. Methods Mortality data of liver cancer in Qidong from 1958 to 1971 (death retrospective survey) and from 1972 to 2017 (cancer registration) were tabulated for the crude rate (CR), and age-standardized rate and age-birth cohorts. The average annual percentage change was calculated by the Joinpoint Regression Program. Results The natural death rate during 1958–2017 decreased from 9‰ to 5.4‰ and then increased to 8‰ as the population aged; cancer mortality rates rose continuously from 57/105 to 240/105. Liver cancer mortality increased from 20/105 to 80/105, and then dropped to less than 52/105 in 2017. Liver cancer deaths in 1972–2017 accounted for 30.53% of all cancers, with a CR of 60.48/105, age-standardized rate China (ASRC) of 34.78/105, and ASRW (world) of 45.71/105. Other key features were the CR for males and females of 91.86/105 and 29.92/105, respectively, with a sex ratio of 3.07:1. Period analysis showed that the ASRs for mortality of the age groups under 54 years old had a significant decreasing trend. Importantly, birth cohort analysis showed that the mortality rate of liver cancer in 40–44, 35–39, 30–34, 25–29, 20–24, 15–19 years cohort decreased considerably, but the rates in 70–74, and 75+ increased. Conclusions The crude mortality rate of liver cancer in Qidong has experienced trends from lower to higher levels, and from continued increase at a high plateau to most recently a gradual decline, and a change greatest in younger people. Many years of comprehensive prevention and intervention measures have influenced the decline of the liver cancer epidemic in this area. The reduction of intake levels of aflatoxin might be one of the most significant factors as evidenced by the dramatic decline of exposure biomarkers in this population during the past three decades.

Analysis of the Curative Effect of Continuous Nursing Based on Data Mining on Patients with Liver Tumors

“…The incidence of liver cancer in my country has been increasing at an annual rate of over 10% in the past 20 years, and it has become one of the most common clinical malignancies [ 27 ]. In recent years, the expertise and advantages of professional nursing in the prevention and treatment of liver cancer have attracted worldwide attention, especially in improving symptoms, improving the quality of life, and prolonging survival [ 28 ].…”

Liver Cancer Survival: A Real World Observation of 45 Years with 32,556 Cases

“…Table 2 and Figure 3 demonstrate that there were significant differences in the survival rates among age groups, with better prognosis at age of 55-64, poor results at aged over 75. Joinpoint Regression shows that the trends of 5-year RS for each age group were increased markedly, but not for the younger aged at 15-24 (Figure 4), since the most younger patients were occurred in the early period 17 when the survival rates were lower as Table 1 showed.…”

“…We have reported that the crude mortality rate of liver cancer in this area had experienced trends from lower to higher levels, and from continued increase at a high plateau to most recently a gradual decline. 17 We believe that many years of comprehensive prevention and intervention measures must have not only influenced the decline of the liver cancer incidence/mortality, but also the survival of the liver cancer patients from the population of this area. Table 1 has showed that the 5-year observed survival (OS) and relative survival (RS) rates during the early calendar years were poor, but improved during the recent years (Figure 2).…”

“…The Qidong Cancer Registry (QCR), a population-based cancer registry was established in 1972 when the Qidong Liver Cancer Institute was run, 16,17 and was designated as a cancer registration repository by the local health authority, with compulsory reporting by health care workers. Several years later, cancer registration was mandated to be compulsory by the provincial health authority.…”

Linc01018 / hsa-mir-182-5p / ADH4 Axis Study on the Role and Mechanism in the Occurrence and Development of Liver Cancer

“…Primary liver cancer, which is widely regarded as one of the most common malignancies all around the world, and its prevalence and mortality are increasing with each passing day [1][2] . Moreover, deaths of liver cancer accounted for 30.53% of all cancer deaths from 1972 to 2017 [3] . At present, the medical treatment of HCC, such as surgical resection [4] , radio-frequency ablation [5] , and liver transplantation can achieve best therapeutic effects [6][7] , but the therapeutic effect and prognosis of HCC are still not optimistic.…”