title: Validation and limitation of age-period-cohort model in simulating mortality due to hepatocellular carcinoma from 1940 to 2010 in Japan.
abstract: OBJECTIVE
  We aimed to simulate the mortality due to hepatocellular carcinoma (HCC) by the age-period-cohort (APC) model with use of sex- and age-specific mortality data, for the purpose of validating the utility and assessing the limitation of this model.
  
  
  METHODS
  Age-specific mortality due to HCC was gleaned from people aged 20-84 years during 1940 through 2010 in Japan.
  
  
  RESULTS
  The APC model had a high performance in reproducing HCC mortality (modified determination coefficient R(2) COR  ≥ 0.99). Risk of HCC increased with age in both sexes, while risk of period barely changed in both sexes. The birth cohort factor in the APC model in males highlighted the maximum point within birth years 1931-1935. The observed HCC mortality in 2010 in males (19 444) was lower than the predicted, and corresponded to 72.3% of the predicted 26 883.4, and in all age groups by 5-year increments (55.6-90.9%). In females, the observed mortality was lower than that predicted in those aged 64 years or less, but not in those aged 65 years or more.
  
  
  CONCLUSIONS
  We applied the APC model to predict HCC mortality rate, and it reproduced the observed mortality rate faithfully. However, in the recent past, the observed morality rate in males was only 72.3% that of the predicted. Such differences would be attributed to combined effects of medical interventions, such as antiviral treatments and screening for hepatitis viruses implemented in the early 1990s in Japan.
authors.affiliation: Department of Epidemiology, Infectious Disease Control and Prevention, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Akita
authors.forename: Masayuki
authors.initials: M
authors.lastname: Ohisa
authors.forename: Yuki
authors.initials: Y
authors.lastname: Kimura
authors.forename: Mayumi
authors.initials: M
authors.lastname: Fujimoto
authors.forename: Yuzo
authors.initials: Y
authors.lastname: Miyakawa
authors.forename: Junko
authors.initials: J
authors.lastname: Tanaka
keywords: age-period-cohort model; epidemiology; hepatitis B virus; hepatitis C virus; hepatocellular carcinoma