Trends and Age-Period-Cohort Effects on the Prevalence, Incidence and Mortality of Hepatocellular Carcinoma from 2008 to 2017 in Tianjin, China

Abstract

Objectives: China is the country most afflicted by hepatocellular carcinoma in the world. However, little is known about the epidemiology of hepatocellular carcinoma in China. This study aimed to examine the trends of the prevalence, incidence, and mortality of hepatocellular carcinoma in China, and to investigate the effects of age, period, and birth cohort on the epidemiological trend. Methods: The data were obtained from the Urban Employee Basic Medical Insurance claims database (2003–2017) in Tianjin, China, which covers 5.95 million individuals. The average annual percentage change of the prevalence, incidence, and mortality were accessed using joinpoint regression. Age-period-cohort models were produced to quantify the effects of age, period, and cohort. Results: The hepatocellular carcinoma prevalence rate increased by 5.13% annually from 20.12/100,000 in 2008 to 30.49/100,000 in 2017, and the incidence rate was almost unchanged, from 13.91/100,000 in 2008 to 14.09/100,000 in 2017, but mortality decreased by 1.80% annually from 8.18/100,000 in 2008 to 7.34/100,000 in 2017. The age-period-cohort analysis revealed that the prevalence rate was remarkably increased from age 25, peaked in age 60, and decreased at age 70 and over. In the period index, the prevalence rate increased gradually from 2008 to 2016, and decreased a little in 2017. In the cohort index, the prevalence rate decreased approximately linearly from the 1925 cohort to the 1990 cohort. The result for the incidence was similar to the prevalence. The mortality rate increased approximately linearly from age 45 to 85, decreased from the 1925 cohort to the 1990 cohort, but it changed a little with the change of period. Conclusions: The findings of this study could inform the necessity of conducting earlier screening for high-risk individuals and improving the treatment of hepatocellular carcinoma, which may also help to predict future changes in hepatocellular carcinoma epidemiology.

Changing epidemiology of hepatocellular carcinoma in Asia

“…The mortality rate of primary liver cancer in males is estimated to be one to three times higher than females in Asian countries, which is associated with the ratio of incidence rate. Several studies also report that ratios of incidence and mortality rates between men and women remained nearly the same within the past decade in China mainland, 7 South Korea 9 and Japan 13 …”

“…In China mainland, the prevalence of HCC increases remarkably from 25 years, peaks at the age of 60 and then decreases after 70, while the mortality rate of HCC increases linearly from ages 45 to 85. 7 In China, Taiwan, the median age at diagnosis is 63 years, and 16.1% of patients diagnosed are older than 75. 8 In South Korea, most female cases of primary liver cancer are diagnosed at age 70-79, whereas most male cases are diagnosed at age 50-59.…”

“…Interestingly, Thailand demonstrates the youngest peak incidence of HCC at the age of 45. In China mainland, the prevalence of HCC increases remarkably from 25 years, peaks at the age of 60 and then decreases after 70, while the mortality rate of HCC increases linearly from ages 45 to 85 7 . In China, Taiwan, the median age at diagnosis is 63 years, and 16.1% of patients diagnosed are older than 75 8 .…”

Identification of Prognostic Genes in Hepatocellular Carcinoma

“…The Urban Employee Basic Medical Insurance Claims Database, between 2003–2017, in Tianjin, China, covers 5.95 million individuals and reports on HCC prevalence. 2 The HCC prevalence rate increased by 5.13% annually from 20.12/100,000 people in 2008 to 30.49/100,000 people in 2017.The prevalence rate increased from 25 years, peaking at 60 years and decreased at ≥70 years. A variety of contributors have been investigated as risk factors for HCC, including hepatitis B virus (HBV), hepatitis C virus (HCV), alcohol and aflatoxin.…”

Circ_SNX27 regulates hepatocellular carcinoma development via miR‐637/FGFR1 axis

“…Hepatocellular carcinoma (HCC) is a primary cancer with a high incidence worldwide 1 . The death rate of HCC patients in China is also quite high 2 . There are many causes of HCC, such as chronic hepatitis B, cirrhosis, diabetes, and fatty liver 3–5 .…”