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Declining rates of hepatocellular carcinoma in urban Shanghai: incidence trends in 1976–2005

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Abstract

In China, hepatocellular carcinoma (HCC) incidence rates in several registry catchment populations are amongst the highest worldwide. The incidence rates in urban Shanghai were analyzed between 1976 and 2005 to describe and interpret the time trends. Age-specific and age-standardized rates were calculated and graphically presented. An age-period-cohort model was fitted to assess the effects of age at diagnosis, calendar period, and birth cohort on the changing HCC incidence rates. In total, 35,241 and 13,931 men and women were diagnosed with HCC during 1976–2005 in urban Shanghai. The age-standardized incidence rates in urban Shanghai were 33.9 per 105 among men and 11.4 per 105 among women in 1976–1980, but decreased in both sexes to 25.8 per 105 and 8.5 per 105, respectively by 2001–2005. Accelerating rates in birth cohorts born in the early-1930s and decelerating rates circa 1945 were observed in both sexes, with further accelerations noted in the late-1950s (in women) and early-1960s (in men). Given the parameterization, increases in risk of HCC were seen in successive male and female generations between 1900 and 1935, followed by a further increase among successive cohorts born around 1960, with a reduction in risk in the most recent generations. The incidence rates of HCC in urban Shanghai from 1976 to 2005 have declined in both sexes, with the complex but similar patterns observed in successive generations suggestive of a shared changing prevalence in risk factors in men and women, with a role possibly for HBV interventions reducing risk of HCC in cohorts born after 1960.

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Acknowledgments

Dr. Puthiery Va, a training fellow from University of New England College of Osteopathic Medicine, was supported by the Fogarty International Clinical Research Scholars and Fellows Support Center at the Vanderbilt Institute for Global Health, funded by the Fogarty International Center, NIH, through an R24 Training Grant (Grant number: R24TW007988). This work was supported by the fund of the state key project specialized for infectious diseases of China (No. 2008ZX10002-015).

Conflict of interest

None declared for all authors.

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Authors and Affiliations

  1. State Key Laboratory of Oncogene and Related Genes, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, No. 25, Lane 2200, Xie Tu Road, 200032, Shanghai, People’s Republic of China

    Shan Gao, Wan-Shui Yang, Wei Zhang, Jing Gao & Yong-Bing Xiang

  2. Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, 200032, Shanghai, People’s Republic of China

    Shan Gao, Wan-Shui Yang, Wei Zhang, Jing Gao & Yong-Bing Xiang

  3. Section of Cancer Information, International Agency for Research on Cancer, 150, Cours Albert Thomas, 69372, Lyon Cedex 08, France

    Freddie Bray

  4. University of New England College of Osteopathic Medicine, 117 Charlton Road, Rochester, NY, 14617, USA

    Puthiery Va

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  1. Shan Gao
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  2. Wan-Shui Yang
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  3. Freddie Bray
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  4. Puthiery Va
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  5. Wei Zhang
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Correspondence to Yong-Bing Xiang.

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Shan Gao and Wan-Shui Yang contributed equally to this work.

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Gao, S., Yang, WS., Bray, F. et al. Declining rates of hepatocellular carcinoma in urban Shanghai: incidence trends in 1976–2005. Eur J Epidemiol 27, 39–46 (2012). https://doi.org/10.1007/s10654-011-9636-8

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  • DOI: https://doi.org/10.1007/s10654-011-9636-8

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