Liver cancer mortality trends during the last 30 years in Hebei province: comparison results from provincial death surveys conducted in the 1970's, 1980's, 1990's and 2004-2005.
OBJECTIVE
Liver cancer is a major health problem in low-resource countries. Approximately 55% of all liver cancer occurs in China. Hebei Province is one of the important covering nearly 6% of the population of China. The aim of this paper was to explore liver cancer mortality trends during past 30 years, and provide basic information on prevention strategies.


METHODS
Hebei was covered covered all the three national surveys during 1973-1975, 1990-1992, and 2004-2005 and one provincial survey during 1984-1986. Subjects included all cases dying from liver cancer in Hebei Province. Liver cancer mortality trend and geographic differences across cities and counties were analyzed.


RESULTS
There were 82,878 deaths in Hebei Province during 2004-2005 with an average mortality rate was 600.9/10,000, and an age-adjusted rate of 552.3/10,000. Those dying of cancer were 18,424 cases, accounting for 22.2% of all deaths, second only to cerebrovascular disease as a cause of death. Cancer mortality was 133.6/100,000 (age-adjusted rate was 119.2/100,000). Liver cancer ranked fourth in this survey with a mortality rate of 21.0/100,000, 28.4/100,000 in males and 13.35/10,000 in females, accounting for 15.7%, 17.1% and 13.4% of the total number of cancer deaths and in males and females, respectively. The sex ratio was 2.13. Since the 1970s, liver cancer deaths of Hebei province have been increasing slightly. The crude mortality rates in the four surveys were 11.3, 16.0, 17.4, 21.0 per 100,000, respectively, with age-adjusted rates fluctuating during the past 30 years, but the trend also being upwards. There is a tendency for the mortality rates to be higher in coastal than mountain areas, and is relative lower in the plain area, with crude mortality rates of 25.3, 22.1, and 19.1 per 100,000, respectively. There were no notable differences in cride data between urban and rural, but the age-adjusted mortality rate in rural was much higher.


CONCLUSIONS
Our study indicated that the mortality of liver cancer in Hebei Province is lower than the national average level. There is a slightly increase trend, especially in some counties. Liver cancer is a major health problem and it is necessary to further promote prevention strategies in Hebei province.
Department of Medical Oncology, Cancer Institute, 4th Hospital of Hebei Medical University, Shijiazhuang, China.
Hong
H
Xu
Yu-Tong
YT
He
Jun-Qing
JQ
Zhu
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008113:Liver Neoplasms / Q000453:epidemiology / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends*; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D055815:Young Adult