研究人员更新HCC死亡率全球趋势，评估2020年预测

StephenW

Researchers update HCC mortality global trends, assess 2020 prediction

Bertuccio P, et al. J Hepatol. 2017;doi:10.1016/j.jhep.2017.03.011.
March 28, 2017

Researchers reviewed the WHO database from 1990 to 2014 to update global trends of hepatocellular mortality and predict trends in rates in Europe, the United States and Japan, according to a recently published study.

“HCC is one of the few major cancer sites showing unfavorable trends in several areas of the world over the last few decades, including the EU, North and Latin America,” the researchers wrote. “Only areas with very high rates in the past, including Japan, Korea and China, showed appreciable declines in rates. Still, over the most recent years, HCC mortality was two- to five-fold higher in Japan, Hong Kong or Korea than in most European countries and the Americas. Steady declines to 2020 are predicted for East Asia but not for Europe and the Americas.”

In men of all ages in Europe and the EU, HCC mortality rates declined from 2002 to 2012 in the Czech Republic (–19.2%), Spain (–14.7%), France (–14%), Italy (–11.8%), Serbia (–12.4%) and Switzerland (–6.7%). Mortality rates increased substantially in Denmark (100.7%), the United Kingdom (67.9%), Romania (64.3%), Portugal (63.6%) and Norway (22%).

In Asia, rates for men declined in Japan (–42.1%), the Republic of Korea (–23.7%) and Hong Kong (–23.7%); however, the authors still considered the rates to be “extremely high” in 2012 (10.2, 23.7 and 12.1 per 100,000, respectively). In the United States, the rate for men increased to 34.8%, but was relatively low in 2002 (2.3-3.1 per 100,000).

Overall female mortality rates declined from 2002 to 2012 in Spain (–39.2%), the Czech Republic (–29.3%), Italy (–25.6%) and Norway (–37.2%), while rates increased in Denmark (97.6%), Romania (47.5%) and the United Kingdom (57.1%). In Asia, rates declined in Japan (–41%), the Republic of Korea (–29%) and Hong Kong (–11), but had higher rates compared with Europe and the Americas (6.1, 3 and 2.6 per 100,000, respectively).

Mortality rates were more favorable in younger patients (20-44 years) than in middle-aged patients (45-59 years). Trends for the younger group decreased in the United States (–30.3%), Australia (–30.6%), Germany (–10.5%) and the United Kingdom (–13%), whereas trends increased for the middle-aged group in the EU (11.1%), the United States (27.9%) and Australia (86.6%).

The researchers predicted that in 2020, per 100,000 men or women, the rates will be 5.4 in men and 1.2 in women in Japan, 3.9 in men and 0.8 in women in the EU, and 3 in men and 0.7 in women in the United States.

“Despite the appreciably higher relative risks for [hepatitis B] and [hepatitis C] than for other factors,” such as heavy alcohol intake, tobacco smoking and aflatoxin, “population attributable risks of HCC vary across different areas of the world according to the prevalence of risk factors. Thus, HBV is the key determinant of HCC in eastern Asia, except Japan, it is HCV in Japan and southern Europe, and diabetes and obesity in North America,” the researchers concluded. “However, mortality is declining in young generations, reflecting the impact of HBV vaccination and improved treatment of HCV. Thus, global future trends in HCC are likely to become more favorable than those registered over the last few decades, particularly in high mortality areas of the world.” – by Talitha Bennett

Disclosure: The researchers report no relevant financial disclosures.

StephenW

研究人员更新HCC死亡率全球趋势，评估2020年预测

Bertuccio P，et al。 J Hepatol 2017; doi：10.1016 / j.jhep.2017.03.011。
2017年3月28日

根据最近发表的研究，研究人员从1990年至2014年审查了世卫组织数据库，以更新全球肝细胞死亡率趋势，并预测欧洲，美国和日本的发病率。

研究人员写道：“HCC是少数主要的癌症网站之一，显示了过去几十年来，包括欧盟，北美和拉丁美洲在内的世界几个地区的不利趋势。 “只有包括日本，韩国和中国在内的过去速度很高的地区，差不多都有明显的下滑。然而，近年来，日本，香港或韩国的HCC死亡率比欧洲大多数国家和美洲高出两到五倍。预计到2020年将稳定下降到东亚，但不是欧洲和美洲。

在欧洲和欧盟各年龄段的男性中，捷克共和国（-19.2％），西班牙（-14.7％），法国（-14％），意大利（-11.8％），2002年至2012年期间，塞尔维亚（跌百分之十二点四）和瑞士（跌百分之六点七）。丹麦（100.7％），英国（67.9％），罗马尼亚（64.3％），葡萄牙（63.6％）和挪威（22％）的死亡率大幅上升。

在亚洲，日本（-42.1％），大韩民国（跌百分之二十三点七）和香港（跌百分之二十三点七）然而，作者仍然认为2012年的利率“极高”（分别为10.2，23.7和12.1每100,000）。在美国，男子比例上升到34.8％，但在2002年相对较低（每100,000人2.3-3.1）。

2002年至2012年，西班牙（-39.2％），捷克共和国（跌百分之二十九点三），意大利（跌百分之二十五点六）和挪威（跌百分之三十七点二）），女性死亡率总体呈下降趋势，而丹麦的比例则上升97.6％罗马尼亚（47.5％）和英国（57.1％）。在亚洲，日本（-41％），大韩民国（跌百分之二十九）和香港（-11）的利率下降，但与欧洲和美洲相比分别下降（分别为6.1,3和2.6每十万）。

年轻患者（20-44岁）的死亡率比中年患者（45-59岁）更为有利。美国（-30.3％），澳大利亚（跌百分之三十点六），德国（跌百分之零点五）和英国（跌百分之十三））下跌趋势，而中年人欧盟（11.1％），美国（27.9％）和澳大利亚（86.6％）。

研究人员预测，到2020年，每100,000名男性或女性中，男性的比例为5.4，在日本的女性为1.2，男性为3.9，在欧洲为女性为男性，女性为男性，男性中为男性为0.7，女性为0.7 。

“尽管[乙型肝炎]和[丙型肝炎]相对风险明显高于其他因素，如重度酒精摄入，吸烟和黄曲霉毒素，”HCC的人口归因风险因世界不同地区而异，根据风险因素流行。研究人员得出结论，HBV是东亚地区HCC的主要决定因素，除了日本，日本和南欧的HCV以及北美的糖尿病和肥胖症。 “然而，年轻一代的死亡率正在下降，反映了乙肝疫苗接种的影响和改善的HCV治疗。因此，HCC的全球未来趋势可能会比过去几十年来更加有利，特别是在世界高死亡率地区。“ - 由Talitha Bennett

披露：研究人员报告没有相关的财务披露。