Attributable causes of liver cancer mortality and incidence in China

• 作 者: Jin-Hu Fan Jian-Bing Wang Hao Liang Wang Xiang Wen-Qiang Wei Sanford M.Dawsey You-Lin Qiao Paolo Boffetta
• 机 构: Department of Cancer Epidemiology, Cancer Institute Hospital, Chinese Academy of Medical Sciences &
• 出 处: 全国肿瘤病因学和肿瘤流行病学学术会议
• 发表日期: 2013年12期

　　Objective: To estimate the proportion of liver cancer cases and deaths due to infection with hepatitis B virus (HBV) and hepatitis C virus (HCV), aflatoxin exposure, alcohol drinking and tobacco smoking in China in 2005.Methods: We estimated the proportion of liver cancer attributable to five known modifiable risk factors [population attributable fraction (PAF)].We obtained exposure data measured in the early 1990s from large-scale national surveys of representative samples of the Chinese population and meta-analyses and data on relative risks from meta-analyses and large-scale observational studies.Data on liver cancer mortality and incidence were from the 3rd national death cause survey and from cancer registries in China.Results: We estimated that HBV infection was responsible for 65.9% of liver cancer deaths in men and 58.4% in women, and HCV was responsible for 27.3% of liver cancer deaths in men and 28.6% in women.The fraction of liver cancer deaths attributable to aflatoxin was estimated to 25.0% for both men and women.Alcohol drinking contributed to 23.4% of liver cancer deaths in men and 2.2% in women.Smoking was responsible for 18.7% of liver cancer deaths among men and 1.0% among women.Overall, 86% of liver cancer (88% in men and 78% in women) mortality and incidence was attributable to these five modifiable risk factors in China.Conclusions: HBV, HCV, aflatoxin, alcohol drinking and tobacco smoking were responsible for 86% of liver cancer mortality and incidence in China in 2005.Our findings could provide useful data for developing guidelines for liver cancer prevention and control in China and other developing countries.