Causes of increased mortality from hepatocellular carcinoma in high incidence country: Taiwan experience
Article first published online: 15 DEC 2004
Journal of Gastroenterology and Hepatology
Volume 20, Issue 4, pages 521–526, April 2005
How to Cite
JAN, C.-F., CHEN, C.-J. and CHEN, H.-H. (2005), Causes of increased mortality from hepatocellular carcinoma in high incidence country: Taiwan experience. Journal of Gastroenterology and Hepatology, 20: 521–526. doi: 10.1111/j.1440-1746.2005.03602.x
- Issue published online: 15 DEC 2004
- Article first published online: 15 DEC 2004
- Accepted for publication 20 March 2004.
- case-fatality rate;
- cohort effect;
- hepatocellular carcinoma;
Background: Since 1991, a rapid rise in mortality from hepatocellular carcinoma (HCC) has been observed in Taiwan in subjects aged ≥20 years. The aim of the present study was to assess whether poor survival or excess incident cases pertaining to a cohort effect or a time-period effect accounted for such a rise.
Methods: A total of 41 150 deaths and 51 201 incident HCC patients (International Classification of Diseases = 155.0) aged 20–79 years between 1985 and 1998 were studied. Trends in HCC mortality rates were divided into two groups: annual case-fatality rates and HCC incidence rates by age. Poisson regression was used to distinguish a cohort effect from a time-period effect on the incidence of HCC.
Results: Subjects aged >50 years after 1991 had the greatest risk of death (relative risk [RR] = 11.3; 95% confidence interval [CI]: 11.0–11.7). Annual case-fatality rates declined from 1.6 in 1985 to 0.84 in 1998, whereas there was a remarkable increase in incidence, particularly from 1991 onward, in the >50-year-olds. It was found that subjects aged >50 years who were born before 1944 were the group most susceptible to HCC (RR = 9.3; 95%CI: 9.1–9.5).
Conclusion: Increased incidence, particularly in individuals over 50, rather than poor survival, accounts for the rapid rise in mortality from HCC.
© 2004 Blackwell Publishing Asia Pty Ltd