Burden of hepatocellular carcinoma in Iran; Bayesian projection and trend analysis

Hepatocellular carcinoma (HCC) is the sixth most prevalent cancer worldwide. Iran is located in a low risk area but, while the true prevalence of HCC in Iran is unknown, it is not an uncommon malignancy. The aim of this study was to provide quantitative estimations of the burden of death due to HCC cancer in Iran and its trend during over recent decades for the Iranian population.

National death statistics reported by the Ministry of Health and Medical Education (MOH and ME) from 1999 to 2004, stratified by age group, sex, and cause of death (ICD-9) were used to generate HCC mortality (ICD-9; 20) expressed as the mortality rate per 100,000 people. The Bayesian approach to correct for misclassification was employed and a time series model was applied to predict mortality. The burden of HCC, including years of life lost (YLL), was calculated using Iranian life expectancy.

The rate of HCC mortality and YLL moderately increased from 1999 to 2004 but according to our prediction it seems that these rates are going to level off. Also HCC mortality and YLL was higher for older age, and was considerably greater in men than in women.

Burden of HCC is low in Iran because most of cases are due to HBV and this infection is less common in Iran than Southeast Asia and Africa and there is nomajor increase projected for the future. However, up to 40% of its death statistics are underreported. Screening can be advised for early HCC detection in chronic HCV and HBV carriers.