Secular trends and geographic variations of hepatitis B virus and hepatitis C virus-associated hepatocellular carcinoma in Taiwan.
Etiological variations in hepatocellular carcinoma (HCC) exist across different geographic areas. To gain better control of HCC, we retrospectively studied the secular trends and geographic variations in hepatitis B virus (HBV)-related and hepatitis C virus (HCV)-related HCCs in Taiwan. A total of 18,423 HCC cases enrolled in 8 medical centers from 1981 to 2001 were reviewed. Overall, 67% of male HCC in Taiwan was related to HBV infection whereas 55.2% of female HCC in Taiwan was related to HCV infection. The mean age of patients with HBV-related HCC was 53.2 +/- 13.6 years, while the mean age of patients with HCV-related HCC was 65.1 +/- 9.1 years (p < 0.001). The male/female ratio was 6.4 for HBV-related HCC, while it was 1.7 for the HCV-related HCC (p < 0.001). The percentage of HBV-related HCC progressively decreased from 81.5 to 66.2% in males, and from 66.7 to 41.4% in females over the study period. Our study demonstrates that the percentage of HBV-related HCC has progressively decreased over the last 20 years. The relative decrease in HBV-related HCC was not due to a decrease in HBV-related HCC death. Instead, it was caused by an increase in HCV-related HCC. Prevention of new HCV infection and the treatment of chronic hepatitis C should be the primary goals, which will result in better control of HCC in the future, even in an HBV-endemic area like Taiwan.
Lu
Sheng-Nan
SN
Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
Su
Wei-Wen
WW
Yang
Sheng-Shun
SS
Chang
Ting-Tsung
TT
Cheng
Ken-Sheng
KS
Wu
Jaw-Ching
JC
Lin
Hans Hsienhong
HH
Wu
Shun-Sheng
SS
Lee
Chuan-Mo
CM
Changchien
Chi-Sin
CS
Chen
Chien-Jen
CJ
Sheu
Jin-Chuan
JC
Chen
Ding-Shinn
DS
Chen
Chien-Hung
CH
D017677:Age Distribution; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology* / Q000209:etiology / Q000821:virology*; D005260:Female; D005843:Geography; D016174:Hepacivirus / Q000502:physiology*; D006509:Hepatitis B / Q000150:complications* / Q000821:virology; D006515:Hepatitis B virus / Q000502:physiology*; D006526:Hepatitis C / Q000150:complications* / Q000821:virology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012727:Sex Characteristics; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors