International trends in hepatocellular carcinoma incidence, 1978–2012
Open accessAbstract
Primary liver cancer, the major histology of which is hepatocellular carcinoma (HCC), is the second leading cause of cancer death worldwide. We comprehensively examined recent international trends of primary liver cancer and HCC incidence using population‐based cancer registry data. Incidence for all primary liver cancer and for HCC by calendar time and birth cohort was examined for selected countries between 1978 and 2012. For each successive 5‐year period, age‐standardized incidence rates were calculated from Volumes V to XI of the Cancer Incidence in Five Continents (CI5) series using the online electronic databases, CI5 plus. Large variations persist in liver cancer incidence globally. Rates of liver cancer remain highest in Asian countries, specifically in the East and South‐East, and Italy. However, rates in these high‐risk countries have been decreasing in recent years. Rates in India and in most countries of Europe, the Americas and Oceania are rising. As the population seroprevalence of hepatitis B virus (HBV) continues to decline, we anticipate rates of HCC in many high‐risk countries will continue to decrease. Treatment of hepatitis C virus (HCV) is likely to bring down rates further in some high‐rate, as well as low‐rate, countries with access to effective therapies. However, such gains in the control of liver cancer are at risk of being reversed by the growing obesity and diabetes epidemics, suggesting diabetes treatment and primary prevention of obesity will be key in reducing liver cancer in the longer‐term.
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Incidence rates in formerly low-risk countries, most countries across Europe, North America, Australia/New Zealand, and South America, have increased or stabilized at a higher level in recent years, possibly in part because of increasing prevalence of metabolic risk factors, such as excess body weight, diabetes, nonalcoholic fatty liver disease, and alcohol consumption.
“Likewise, incidence rates in formerly low-risk countries, most countries across Europe, North America, Australia/New Zealand, and South America have increased or stabilized at a higher level in recent years, 125,128 possibly in part because of increasing prevalence of metabolic risk factors, such as excess body weight, diabetes, nonalcoholic fatty liver disease, and alcohol consumption.”
From Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. (2024) · cites this paper as [125]
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Experimental — accuracy not yet measuredIn countries like Thailand, where HCC represents less than 30% of liver cancer, liver cancer incidence rates continue to rise despite the decline in HCC rates.
“In contrast, in countries like Thailand, where HCC represents less than 30% of liver cancer, liver cancer incidence rates continue to rise despite the decline in HCC rates.125”
From Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. (2024) · cites this paper as [125]
The Results report that HCC accounted for 27% of liver cancers with microscopic verification in Thailand, and that primary liver cancer incidence rose while HCC incidence fell sharply since 2000. The claim accurately describes the opposing trends but omits that the percentage applies only to microscopically verified cancers. (LLM, conf=0.86)
Experimental — accuracy not yet measuredWith declines in the population seroprevalence of HBV and HCV, as well as a reduction in aflatoxin exposure, liver cancer rates have been declining steadily in many high-risk countries in East and South-Eastern Asia since the late 1970s and in Japan and China since the 1990s.
“With declines in the population seroprevalence of HBV and HCV, as well as a reduction in aflatoxin exposure, liver cancer rates have been declining steadily in many high-risk countries in East and South-Eastern Asia since the late 1970s and in Japan and China since the 1990s.63,125,126”
From Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. (2024) · cites this paper as [125]
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“…countries across Europe, North America, Australia/New Zealand, and South America have increased or stabilized at a higher level in recent years, 125,128 possibly in part because of increasing prevalence of metabolic risk factors, such as excess body weight, diabetes, nonalcoholic fatty liver…”
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- Authors
- Petrick, J. L., Florio, A. A., Znaor, A., Ruggieri, D., Laversanne, M., Alvarez, C. S., Ferlay, J., Valery, P. C., Bray, F., & McGlynn, K. A.
- Affiliations
- Boston University (US)
- National Cancer Institute (US)
- Centre international de recherche sur le cancer (FR)
- Information Management Services (US)
- Division of Cancer Epidemiology and Genetics National Cancer Institute Bethesda MD
- QIMR Berghofer Medical Research Institute (AU)
- Corresponding author
- Petrick, Jessica L.
- ORCID
- Venue
- International Journal of Cancer
- Publisher
- Wiley
- Published
- 2019-11-05
- Volume
- 147
- Issue
- 2
- Pages
- 317-330
- ISSN
- 0020-7136 (ISSN-L)
- 1097-0215
- PMC
- PMC7470451
- OpenAlex
- W2980064491
- Cited by
- 594
- References
- 47
- Citations by year
- 2026: 49 · 2025: 100 · 2024: 116 · 2023: 129 · 2022: 117 · 2021: 63 · 2020: 17 · 2019: 1
- FWCI
- 31.56
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- International Journal of Cancer (publishedVersion, cc-by)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Cancer Institute
- Topics
- Health Sciences › Medicine › Hepatology › Hepatocellular Carcinoma Treatment and Prognosis
- Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
- Health Sciences › Medicine › Epidemiology › Hepatitis B Virus Studies
- Keywords
- hepatocellular carcinoma, primary liver cancer, cancer incidence trends, birth cohort analysis, age-standardized incidence rate, hepatitis B virus, hepatitis C virus, obesity, diabetes mellitus, global cancer epidemiology, incidence decline
- MeSH terms
- Africa, Asia, Europe, Female, Hepatitis B, Hepatitis C, Carcinoma, Hepatocellular, Humans, India, Liver Neoplasms, Male, Registries, Incidence, Seroepidemiologic Studies
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