Trends in primary liver cancer

Abstract

Simon Taylor-Robinson and colleagues (Oct 18, p 1142)1Taylor-Robinson SD Foster GR Arora S Hargreaves S Thomas HC Increase in primary liver cancer in the UK, 1979–94.Lancet. 1997; 350: 1142-1143Summary Full Text Full Text PDF PubMed Scopus (472) Google Scholar report an increase in primary liver cancer in the UK in 1979–94, and suggest it could be caused by a hepatitis C virus (HCV) epidemic. A similar trend was observed in France (figure). Between 1979 and 1994, mortality from all causes of primary liver cancer (ICD9 155·0) increased four-fold for men (from 842 to 3545) and two-fold for women (from 326 to 790). Mortality rates were age-standardised according to the French population in 1979. Between 1979 and 1994, the age-standardised mortality rates per 100 000 people increased from 3·2 to 11·1 in men and from 1·2 to 2·5 in women. There has been much improvement in the detection of liver cancer, but ultrasonography and measurement of serum α-fetoprotein have been routinely used since 1980 and could not explain the increase in mortality observed between 1985 and 1994. Our recent work on natural history of HCV infection,2Deuffic S Buffat L Poynard T Valleron A-J La modélisation de l'histoire naturelle de l'epidémie d'hépatite C permet de prédire une augmentation considérable de la mortalité par cancer primitif du foie. 41es Journées de l' Association Française pour l'Etude du Foie, Strasbourg1997Google Scholar with a model of fibrosis progression,3Poynard T Bedossa P Opolon P for the OBSVIRC, METAVIR, CLINIVIR, and DOSVIRC GroupsNatural history of liver fibrosis progression in patients with chronic hepatitis C.Lancet. 1997; 349: 825-832Summary Full Text Full Text PDF PubMed Scopus (2769) Google Scholar showed that HCV infection could explain the rise in mortality from liver cancer.