title: Trends in liver cancer, Sa Kaeo Province Thailand.
abstract: OBJECTIVE
  To determine liver cancer trends in Sa Kaeo Province, Thailand.
  
  
  METHODS
  Death certificate (1993-2003) and hospital records (1999-2003) were reviewed and compared to national averages and other provinces.
  
  
  RESULTS
  According to data from death certificates, liver cancer mortality in Sa Kaeo Province increased from 3.1 to 26.1 per 100,000 population between 1993 and 2003. In Thailand overall rates increased from 9.0 to 19.8 per 100,000 population between 1996 and 2003. According to electronic hospital records, the total number of patient encounters (in-patient admissions and out-patient visits) for liver cancer in the two main hospitals in Sa Kaeo Province increased 56% (14% annually) between 1999 and 2003. The number of cases of hepatocellular carcinoma increased from 42 in 2001 to 73 in 2003, while the number of cases of cholangiocarcinoma showed little change.
  
  
  CONCLUSIONS
  Thailand as a whole and Sa Kaeo Province specifically have a high burden of liver cancer, which appears to have increased substantially in the past 10 years. Demonstrating the impact of ongoing strategies aimed at reducing risk factors for liver cancer, such as universal hepatitis B vaccination of infants, will require reliable data describing liver cancer disease burden and etiology. Rapid investigations using available data from death certificates, electronic admissions records, and patient charts can provide valuable insights on disease burden and trends.
authors.affiliation: Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. joe_j_amon@yahoo.com
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Amon
authors.forename: Supalert
authors.initials: S
authors.lastname: Nedsuwan
authors.forename: Somrak
authors.initials: S
authors.lastname: Chantra
authors.forename: Beth P
authors.initials: BP
authors.lastname: Bell
authors.forename: Scott F
authors.initials: SF
authors.lastname: Dowell
authors.forename: Sonja J
authors.initials: SJ
authors.lastname: Olsen
authors.forename: Annemarie
authors.initials: A
authors.lastname: Wasley
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000401:mortality*; D002648:Child; D002675:Child, Preschool; D003644:Death Certificates; D005260:Female; D006509:Hepatitis B / Q000150:complications; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008113:Liver Neoplasms / Q000401:mortality*; D008297:Male; D008499:Medical Records / Q000706:statistics & numerical data; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D012189:Retrospective Studies; D012307:Risk Factors; D013785:Thailand / Q000453:epidemiology