Epidemiology of Primary Liver Cancer

Cancer of the liver is a significant cause of morbidity and mortality worldwide. Globally, 625,000 cases of liver cancer were reported in 2002. The worldwide distribution of liver cancer is characterised by a great geographic variability, with age-standardised incidence rates ranging from more than 30 cases per 100,000 population in eastern Asia and parts of Africa, to fewer than five per 100,000 in the Americas and in Northern Europe. Much of this variability in the distribution of the disease is related to the global distribution and the natural history of infection with hepatitis B and C viruses. In Australia, both the incidence of and mortality from liver cancer have been progressively rising since the mid-1980s. The age standardised incidence rates for liver cancer are highest in some overseas-born Australians, especially among those born in hepatitis B and C endemic countries. The incidence of primary liver cancer in Australia is projected to continue to rise over the next two decades, as a result of a large reservoir of asymptomatic infections with chronic viral hepatitis, immigration from countries of high hepatitis B virus prevalence and the slow disease progression from chronic hepatitis B virus infection to liver cancer. Public health strategies for targeted interventions for the prevention, treatment and control of chronic viral hepatitis infection may effectively reduce the burden of liver cancer globally, as well as in Australia.