Abstract
Background and Methods: To provide information on poorly described Canadian hepatocellular cancer epidemiology, we analyzed incident cases abstracted from the Canadian Cancer Registration Database (1969–1997) and Canadian annual death data (1969–1998). Age, sex, geographic distribution, and secular trends were described. Projection models were developed for the next decade.
Results: Results indicated much higher incidence and mortality rates in males than females, with substantial increases for both with age. Age-standardized incidence rates increased an average of 3.4% per year in males, 1.2% per year in females (1969–1997). Age-standardized mortality rates increased an average of 1.48% in males, but decreased an average of 0.46% per year in females (1969–1998). Joinpoint analysis of the linear trends in the age-standardized incidence and mortality rates suggested that a new trend started to emerge about 1991. The fitted non-linear multiplicative model predicted the occurrence of 1,565 new cases and 802 deaths in the year 2010. HCC incidence was the highest in British Colombia, followed by Quebec, and the lowest in the Atlantic region.
Conclusions: Incidence rates of hepatocellular carcinoma have increased substantially, consistent with the reported increase in the prevalence of Hepatitis C Virus (HCV) and Hepatitis B Virus (HBV) infections in recent decades.
Résumé
Contexte et méthodes: Afin de combler le manque d’information sur l’épidémiologie du cancer hépatocellulaire au Canada, qui a été peu décrite jusqu’à maintenant, nous avons analysé les nouveaux cas tirés de la base de données du Registre canadien du cancer (1969–1997) et les données annuelles sur la mortalité au Canada (1969–1998). L’âge, le sexe, la répartition géographique et les tendances à long terme ont fait l’objet d’une description. Des modèles de projection ont été élaborés pour la prochaine décennie.
Résultats: Les résultats indiquent des taux d’incidence et de mortalité beaucoup plus élevés chez les hommes que chez les femmes. Pour les hommes comme pour les femmes, on observe une importante croissance des taux avec l’âge. Les taux d’incidence normalisés selon l’âge ont augmenté en moyenne de 3,4% par année chez les hommes et de 1,2% par année chez les femmes (1969–1997). Les taux de mortalité normalisés selon l’âge ont augmenté en moyenne de 1,48% chez les hommes, mais ont diminué en moyenne de 0,46% par année chez les femmes (1969–1998). L’analyse par point de retournement des tendances linéaires des taux d’incidence et de mortalité normalisés selon l’âge suggère l’émergence d’une nouvelle tendance vers 1991. Le modèle multiplicatif non linéaire ajusté prévoit la survenue de 1 565 nouveaux cas et de 802 décès en 2010. C’est en Colombie-Britannique, suivie du Québec, qu’on trouve l’incidence la plus élevée de CHC, alors que l’incidence la plus basse s’observe dans la région de l’Atlantique.
Conclusions: Les taux d’incidence du carcinome hépatocellulaire ont augmenté de façon notable, ce qui est compatible avec l’augmentation signalée de la prévalence de l’infection par le virus de l’hépatite C (VHC) et de l’infection par le virus de l’hépatite B (VHB) dans les dernières décennies.
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