Hepatocellular carcinoma epidemiology and demographics

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Dildar Hussain, MBBS [2] Mohamad Alkateb, MBBCh [3]

Overview

Hepatocellular carcinoma is the 5th most common tumor worldwide. The epidemiology of hepatocellular carcinoma exhibits two main patterns, one in North America and Western Europe and the other in non-Western countries, such as those in Sub-Saharan Africa, Central Asia, Southeast Asia, and the Amazon basin. Men are affected more than women and it is more common between the 4th and 5th decades of life. Hepatocellular carcinoma causes 662,000 deaths worldwide annually.

Epidemiology and Demographics

The epidemiology of hepatocellular carcinoma exhibits two main patterns, one in North America and Western Europe and the other in non-Western countries, such as those in Sub-Saharan Africa, Central Asia and Southeast Asia, and the Amazon basin. Although the incidence of hepatocellular carcinoma is increasing worldwide due to its association with viral infections; it still remains relatively uncommon in the United States and Western Europe. HCC is the fastest-growing cause of cancer-related deaths and the second most common cause of mortality among women.[1][2][3][4]

Incidence

In almost 90% of the cases Hepatocellular carcinoma patients have underlying liver cirrhosis.[5][6]

  • The incidence of Hepatocellular carcinoma is described below:[5][7][8]
  • In 1975-77, the incidence of Hepatocellular carcinoma in the United States was 1.4 per 100,000 which increased to 4.8 per 100,000 in 2005-2007.[9]
  • In 2007, the incidence of Hepatocellular carcinoma was estimated to be over 20 cases per 100,000 persons in sub-Saharan Africa, and Eastern Asia.
  • In 2007, the incidence of Hepatocellular carcinoma was estimated to be 10-20 per 100,000 persons in Mediterranean countries such as Italy, Spain, and Greece.
  • In 2007, the incidence of Hepatocellular carcinoma was estimated to be <5 per 100,000 persons in North and South America.
  • In 2010, the incidence of Hepatocellular carcinoma was estimated to be 6 per 100,000 persons in the USA.[10]
  • In 2012, the incidence of Hepatocellular carcinoma was estimated to be 10.6 per 100,000 persons among Latinos in Texas.[11]
  • in 2014, the incidence of Hepatocellular carcinoma was estimated to be over 20 per 100,000 persons in sub-Saharan Africa and Eastern Asia.[12]

Prevalence

  • In 2012, 0.8 million cases were diagnosed with Hepatocellular carcinoma worldwide.[13][6]

Case-fatality rate/Mortality rate

  • It is estimated that that 28,920 deaths (19,610 men and 9,310 women) will occur due to hepatocellular carcinoma in the United States.[14]

Age

Hepatocellular carcinoma is more common between the 4th and 5th decades of life.[10]

Race

  • Hepatocellular carcinoma is reported highest among the Asians and Pacific Islanders followed by Hispanics, Blacks, American Indians/Alaska Natives, and Whites race.[15]

Gender

Males are three times more affected than females.[16]

Region

  • The majority of hepatocellular carcinoma cases are reported in Asia.[17]

Developed Countries

Hepatocellular carcinoma is generally a rare tumor in the West. Metastasis from other parts of the body is the main cause for developing hepatocellular carcinoma in the western countries. Due to the advancement in the health care system in the western countries, hepatocellular carcinoma is usually discovered at early stages in comparison to the developing countries such as Sub-Saharan Africa.

Developing Countries

In some parts of the world, such as Sub-Saharan Africa and Southeast Asia, hepatocellular carcinoma is the most common cancer. It affects men more than women and the age of onset is between late teens and early 30s. This variation is due to the different methods of hepatitis B transmission in different populations. For example, infection at or around birth predisposes to earlier cancers than if people are infected later. The time to develop hepatocellular carcinoma after hepatitis B infection can vary from years to decades. The average survival time from the time of hepatocellular carcinoma diagnosis to death is about 5.9 months and about 3 months (median survival time) in Sub-Saharan Africa according to Manson's textbook of tropical diseases. Hepatocellular carcinoma is one of the deadliest cancers in China.

References

  1. Papadopoulos N, Argiana V, Deutsch M (2018). "Hepatitis C infection in patients with hereditary bleeding disorders: epidemiology, natural history, and management". Ann Gastroenterol. 31 (1): 35–41. doi:10.20524/aog.2017.0204. PMID 29333065.
  2. Didi-Kouko Coulibaly, Judith; Yeboua, Mireille; Kouassi Mbengue, Alphonsine; Kouadio, Emile Allah; Anzouan-Kacou Kissi, Henriette; Binan, Allah Yves-Omer; Lohoues Kouacou, Marie-Jeanne; Attia, Alain; N’Drin, Dominique Yao; Toutou, Toussaint; Adoubi, Innocent; Pineau, Pascal (2017). "Evolution of hepatocellular carcinoma epidemiology in Côte d'Ivoire". Bulletin du Cancer. 104 (11): 937–945. doi:10.1016/j.bulcan.2017.09.010. ISSN 0007-4551.
  3. "Cancer". World Health Organization. February 2006. Retrieved 2007-05-24.
  4. Budny A, Kozłowski P, Kamińska M, Jankiewicz M, Kolak A, Budny B, Budny W, Niemunis-Sawicka J, Szczypiór G, Kurniawka B, Burdan F (2017). "[Epidemiology and risk factors of hepatocellular carcinoma]". Pol. Merkur. Lekarski (in Polish). 43 (255): 133–139. PMID 28987047.
  5. 5.0 5.1 Colombo, Massimo; de Franchis, Roberto; Del Ninno, Ersilio; Sangiovanni, Angelo; De Fazio, Cristina; Tommasini, Maurizio; Donato, M. Francesca; Piva, Anna; Di Carlo, Valerio; Dioguardi, Nicola (1991). "Hepatocellular Carcinoma in Italian Patients with Cirrhosis". New England Journal of Medicine. 325 (10): 675–680. doi:10.1056/NEJM199109053251002. ISSN 0028-4793.
  6. 6.0 6.1 Rowe, JulieH; Ghouri, YezazAhmed; Mian, Idrees (2017). "Review of hepatocellular carcinoma: Epidemiology, etiology, and carcinogenesis". Journal of Carcinogenesis. 16 (1): 1. doi:10.4103/jcar.JCar_9_16. ISSN 1477-3163.
  7. Mittal S, El-Serag HB (2013). "Epidemiology of hepatocellular carcinoma: consider the population". J. Clin. Gastroenterol. 47 Suppl: S2–6. doi:10.1097/MCG.0b013e3182872f29. PMC 3683119. PMID 23632345.
  8. El-Serag HB, Lau M, Eschbach K, Davila J, Goodwin J (2007). "Epidemiology of hepatocellular carcinoma in Hispanics in the United States". Arch. Intern. Med. 167 (18): 1983–9. doi:10.1001/archinte.167.18.1983. PMID 17923599.
  9. Davila JA, El-Serag HB. The Rising Incidence of Hepatocellular Carcinoma in the United States: an Update. Gastroenterology. 2012;142(suppl 1):S914–S914.
  10. 10.0 10.1 El-Serag, Hashem B.; Kanwal, Fasiha (2014). "Epidemiology of hepatocellular carcinoma in the United States: Where are we? Where do we go?". Hepatology. 60 (5): 1767–1775. doi:10.1002/hep.27222. ISSN 0270-9139.
  11. Lee, Jung Eun; Ramirez, Amelie G.; Weiss, Nancy S.; Holden, Alan E. C.; Suarez, Lucina; Cooper, Sharon P.; Munoz, Edgar; Naylor, Susan L. (2012). "Incidence and Risk Factors for Hepatocellular Carcinoma in Texas Latinos: Implications for Prevention Research". PLoS ONE. 7 (4): e35573. doi:10.1371/journal.pone.0035573. ISSN 1932-6203.
  12. Mittal, Sahil; El-Serag, Hashem B. (2013). "Epidemiology of Hepatocellular Carcinoma". Journal of Clinical Gastroenterology. 47: S2–S6. doi:10.1097/MCG.0b013e3182872f29. ISSN 0192-0790.
  13. World Health Organization, I.A.f.R.o.C. Estimated Cancer Incidence, Mortality and Prevalence Worldwide in 2012. Available from: http://www.globocan.iarc.fr/Pages/fact_sheets_population.aspx
  14. "Liver Cancer: Statistics | Cancer.Net".
  15. Altekruse, Sean F.; McGlynn, Katherine A.; Reichman, Marsha E. (2009). "Hepatocellular Carcinoma Incidence, Mortality, and Survival Trends in the United States From 1975 to 2005". Journal of Clinical Oncology. 27 (9): 1485–1491. doi:10.1200/JCO.2008.20.7753. ISSN 0732-183X.
  16. El-Serag, Hashem B.; Kanwal, Fasiha (2014). "Epidemiology of hepatocellular carcinoma in the United States: Where are we? Where do we go?". Hepatology. 60 (5): 1767–1775. doi:10.1002/hep.27222. ISSN 0270-9139.
  17. El-Serag, Hashem B.; Kanwal, Fasiha (2014). "Epidemiology of hepatocellular carcinoma in the United States: Where are we? Where do we go?". Hepatology. 60 (5): 1767–1775. doi:10.1002/hep.27222. ISSN 0270-9139.

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