Secular trend in universal hepatocellular carcinoma prevention: Taiwan, Poland, and Belgium experience

Liver cancer poses a significant public health threat. The difference between disease patterns and national policies is crucial to elucidating factors influencing hepatocellular carcinoma (HCC) incidence.

To investigate the secular trend and disease pattern of liver cancer in Taiwan, Poland, and Belgium.

This population-based cohort study presents the incidence, period, and cohort effects in HCC incidence between 2000 and 2019 in Taiwan, Poland, and Flanders, Belgium. Data on HCC were obtained from cancer registry data from Taiwan, Poland, and regional data from Belgium. Age-standardized incidence rates (ASIRs), annual percentage changes, and age-period-cohort analyses were conducted by sex and period.

Taiwan's ASIR decreased from 2000 to 2019 (males: 55.17 to 43.42, females: 21.91 to 16.20, per 100000). In Poland, ASIR declined from 2000 to 2019 (males: 3.21 to 2.77, females: 1.95 to 1.32, per 100000). However, Flanders experienced an increase in ASIR from 2000 to 2019 (males: 2.66 to 5.63, females: 1.40 to 2.20, per 100000). In Taiwan, the cohort effect rate ratio increased from 1915 to 1935 (males: 1.02 to 1.36, females: 1.04 to 1.54) and decreased from 1935 to 1989 (males: 1.36 to 0.22, females: 1.54 to 0.20). In Poland, rate ratios consistently decreased (males: 1.75 to 0.25, females: 3.46 to 0.26). Flanders exhibited an increase in both males (0.14 to 2.52, 1915 to 1975) and females (0.53 to 3.66, 1915 to 1989).

Taiwan and Poland's declining ASIR may be due to effective hepatitis B virus immunization and viral hepatitis therapy. Flanders' persistent increase may be tied to higher HCC risk in high hepatitis C virus risk populations.