title: Rising incidence of primary liver cancer in Brunei Darussalam.
abstract: BACKGROUND
  Primary liver cancer (PLC) is the fifth most common malignancy worldwide and is still associated with high mortality. Hepatocellular carcinoma (HCC) and cholangiocarcinoma are the two most common PLCs, and their incidence varies across regions. Currently there are no published data available on the incidence of PLC in Brunei Darussalam.
  
  
  METHODS
  All proven PLCs between 2000 and 2009 were identified from the National Cancer Registry and reviewed. Metastatic diseases were excluded. A total of 123 cases (male 65.8%, female 34.2%) were identified and their data collected for calculation of the age standardised rate (ASR).
  
  
  RESULTS
  The most common type of PLC was HCC (87.8%) followed by cholangiocarcinoma (10.6%). There were two cases of hepatoblastoma. The mean age at diagnosis was 63.2 years. The overall ASR of PLC was 8.2/100,000, increasing from 4.5/100,000 population in 2000 to 11.4/100,000 population in 2009. The rates were higher among males (12.0/100,000) than females (4.7/100,000). Among the ethnic groups, Chinese had the highest rates (overall 13.1/100,000 with none recorded in 2000 to 30.3/100,000 in 2009) compared to the Malays (overall 8.5/100,000 increasing from 4.5/100,000 in 2000 to 12.3/100,000 in 2009) and the indigenous groups. The incidence increased after the age of 50 and was highest among the 75-79 age groups. Increase was seen for HCC but not for cholangiocarcinoma.
  
  
  CONCLUSIONS
  The most common type of PLC is HCC and the annual incidence of PLC is increasing in Brunei Darussalam,rates being higher in males and Chinese.
authors.affiliation: Pengiran Anak Puteri Rasidah Sa'adatul Bolkiah Institute of Health Science, Universiti of Brunei Darussalam, Brunei Darussalam.
authors.forename: Raymond Jih Yeong
authors.initials: RJ
authors.lastname: Chong
authors.forename: Mohd Syafiq
authors.initials: MS
authors.lastname: Abdullah
authors.forename: Mohammad Moshaddeque
authors.initials: MM
authors.lastname: Hossain
authors.forename: Pemasari Upali
authors.initials: PU
authors.lastname: Telisinghe
authors.forename: Vui Heng
authors.initials: VH
authors.lastname: Chong
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology; D001653:Bile Ducts, Intrahepatic / Q000473:pathology*; D002010:Brunei / Q000453:epidemiology; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D018281:Cholangiocarcinoma / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008113:Liver Neoplasms / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D015996:Survival Rate; D055815:Young Adult