Primary hepatocellular carcinoma in Australia, 1978‐1997: increasing incidence and mortality

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Abstract
Objectives To describe trends in primary hepatocellular carcinoma (HCC) incidence and mortality in Australia between 1978 and 1997, and to delineate the effects of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection by examining cases of HCC in Australian‐born and overseas‐born people separately. Design and setting Retrospective analysis of national incidence and mortality data in which the underlying cause was coded as HCC (International classification of diseases, ninth revision [ICD‐9] code 155.0). Main outcome measures Changes in age‐standardised HCC incidence rates in men and women between 1983 and 1996; age‐standardised HCC death rates in Australian‐born and overseas‐born men and women between 1978 and 1997. Results Age‐standardised incidence rates increased in men and women (from 2.06 and 0.57 per 100000 respectively in 1983–1985 to 3.97 and 0.99 respectively in 1995–1996). Age‐standardised death rates increased in Australian‐born and overseas‐born men and overseas‐born women (from 1.43, 2.35 and 0.62 respectively per 100000 in 1978–1982 to 2.50, 4.41 and 1.36 respectively in 1993–1997). However, death rates in Australian‐born women did not increase (0.58 per 100000 in 1978–1982 and 0.63 in 1993–1997). Conclusions HCC incidence and death rates in Australia have increased over the past two decades, except in Australian‐born women. A likely explanation for at least a portion of this increase is increased prevalences of HBV and HCV infection in Australia.