Global Projections Of Primary Liver Cancer To 2030

Patricia VALERY, QIMR Berghofer Medical Research Institute, Australia

1 Population Health, QIMR Berghofer Medical Research Institute, Brisbane, Australia
2 Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
3 Division of Cancer Epidemiology & Genetics, National Cancer Institute, Bethesda, USA

Purpose: To predict the future incidence of primary liver cancer (PLC) for selected countries.
Methods: New cases of PLC (ICD-10 C22) diagnosed in 30 countries worldwide were available from cancer registries via CI5plus for the period 1993-2007. Observed trends were extrapolated from age-period-cohort models (NORDPRED) to estimate the future burden of PLC to 2030 by sex. Age-standardized incidence rates (ASR) per 100,000 person-years were predicted by country and sex.
Results: Among men and women, the vast majority of countries will see an increasing burden over the next 15 years. Among women, about half of the countries will see an increase in ASR. We estimate that, in 2030, there will be 175,077 new cases of PLC among men annually and 94,005 among women in the selected countries. This represents at least a twofold increase in the number of new cases in both sexes compared with 2005, a rise of 108% and 133%, respectively. Some of the most rapid ASR increases among men and women are observed in Brazil (6.5% per annum), USA blacks (3.1%), and Poland (3.4%). Rapid decreases in PLC among men and women are observed in Japan, Singapore, and Slovakia.
Conclusions: Despite heterogeneity of the predicted rates, the number of PLC cases is set to continue to increase in many countries over the next decades. Regional differences in the prevalence of hepatitis B and hepatitis C (HCV) virus infections, dietary aflatoxin exposure, obesity, and alcohol-related cirrhosis may explain some of the rate variations. Increasing rates in some countries may be partly the consequence of HCV acquired during the 1960-1970s. However, projections could be affected by treatment rates of HCV infection. Public health measures aimed at reducing HCV infection, and hence transmission, are likely to have contributed to the decrease in rates in others (e.g. Japan).
Funding: NHMRC fellowship* 1083090.