Excess mortality from hepatocellular carcinoma in an HCV-endemic township of an HBV-endemic country (Taiwan).
- 1 November 1999
- journal article
- Published by Oxford University Press (OUP) in Transactions of the Royal Society of Tropical Medicine and Hygiene
- Vol. 93 (6) , 600-602
- https://doi.org/10.1016/s0035-9203(99)90063-9
Abstract
Taiwan is an endemic area of hepatitis B virus (HBV). All previous studies have concluded that HBV is the major cause of hepatocellular carcinoma (HCC) in Taiwan. An HBV- and hepatitis C virus (HCV)-endemic township, Tzukuan, in southern Taiwan has been identified with the prevalence of 24% for HB surface antigen (HBsAg) and 37% for anti-HCV antibodies. To elucidate the aetiology of HCC and impact of HCV in this township, we conducted a case-control study and compared HBV-related liver cancer mortality in Tzukuan and Taiwan as a whole. Based on cancer registration datasets of 2 medical centres from 1991 to 1995, we recruited 18 male and 9 female HCC cases from the study township. Their mean age (±standard deviation) was 60·3 (± 7.3) years. Randomly sampled from a community-based survey, 4 age- (± 2 years) and sex-matched residents were selected as community controls for each HCC case. The HBsAg carrier rate was 40·7% in cases and 25·0% in controls (P = 0·1). Anti-HCV positive rate was 88·9% in cases and 53·7% in controls (P = 0·008). Age-adjusted liver cancer mortality in Tzukuan (36·5 per 105) was significantly higher than that of Taiwan as a whole (20 per 105). Based on the HBsAg-positive rate among HCC patients (40·7% in Tzukuan and 77·4–86·6% in Taiwan), the estimated HBV-related liver cancer mortality was similar in Tzukuan (14·9 per 105) and Taiwan (15·8–17·3 per 105). We concluded that HCV was the major risk factor for excess liver cancer mortality in this HCV-endemic township of the HBV-endemic country.Keywords
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