title: Secular trends and geographic variations of hepatitis B virus and hepatitis C virus-associated hepatocellular carcinoma in Taiwan.
abstract: 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.
authors.affiliation: Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
authors.forename: Sheng-Nan
authors.initials: SN
authors.lastname: Lu
authors.forename: Wei-Wen
authors.initials: WW
authors.lastname: Su
authors.forename: Sheng-Shun
authors.initials: SS
authors.lastname: Yang
authors.forename: Ting-Tsung
authors.initials: TT
authors.lastname: Chang
authors.forename: Ken-Sheng
authors.initials: KS
authors.lastname: Cheng
authors.forename: Jaw-Ching
authors.initials: JC
authors.lastname: Wu
authors.forename: Hans Hsienhong
authors.initials: HH
authors.lastname: Lin
authors.forename: Shun-Sheng
authors.initials: SS
authors.lastname: Wu
authors.forename: Chuan-Mo
authors.initials: CM
authors.lastname: Lee
authors.forename: Chi-Sin
authors.initials: CS
authors.lastname: Changchien
authors.forename: Chien-Jen
authors.initials: CJ
authors.lastname: Chen
authors.forename: Jin-Chuan
authors.initials: JC
authors.lastname: Sheu
authors.forename: Ding-Shinn
authors.initials: DS
authors.lastname: Chen
authors.forename: Chien-Hung
authors.initials: CH
authors.lastname: Chen
mesh_terms: 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