title: Hepatocellular carcinoma incidence trends in Canada: analysis by birth cohort and period of diagnosis.
abstract: OBJECTIVE
  We examined birth cohort and calendar period trends in hepatocellular carcinoma (HCC) incidence in Canada (1976-2000). We also projected HCC incidence rates through 2015.
  
  
  METHODS
  Data were obtained from the Canadian Cancer Registry on all cases of HCC diagnosed among persons aged 20 years and older in Canada from 1976 to 2000 and was used to describe trends in HCC incidence rates.
  
  
  RESULTS
  We found that age-adjusted HCC incidence rates increased faster in males compared with females, 3.4% per year [95% confidence interval (CI): 3.0-3.8%] vs 2.2% per year (95% CI: 1.5-2.8%). An increasing birth cohort trend accelerated among males around the 1940 birth cohort and decelerated among females around the 1935 birth cohort. For calendar period trends, the increasing HCC risk was relatively constant over time among males whereas there was an acceleration in HCC risk around 1988 among females. Age-adjusted HCC incidence rates were projected to increase 73% in males and 28% in females from 1996 to 2015.
  
  
  CONCLUSIONS
  Our results suggest that HCC incidence rates will continue to increase in Canada during the next decade as persons born in more recent birth cohorts, who face a relatively greater risk for HCC, age.
authors.affiliation: Department of Epidemiology, University of Washington, WA, USA. gpocobel@u.washington.edu
authors.forename: Gaia
authors.initials: G
authors.lastname: Pocobelli
authors.forename: Linda S
authors.initials: LS
authors.lastname: Cook
authors.forename: Rollin
authors.initials: R
authors.lastname: Brant
authors.forename: Samuel S
authors.initials: SS
authors.lastname: Lee
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002170:Canada / Q000453:epidemiology; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000453:epidemiology*; D015331:Cohort Studies; D005260:Female; D005544:Forecasting; D006801:Humans; D015994:Incidence; D016013:Likelihood Functions; D008113:Liver Neoplasms / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D055815:Young Adult