Hideo Tanaka, MD; Yasuharu Imai, MD; Naoki Hiramatsu, MD; Yuri Ito, PhD; Kazuho Imanaka, MD; Masahide Oshita, MD; Taizo Hijioka, MD; Kazuhiro Katayama, MD; Iwao Yabuuchi, MD; Harumasa Yoshihara, MD; Atsuo Inoue, MD; Michio Kato, MD; Tetsuo Takehara, MD; Shinji Tamura, MD; Akinori Kasahara, MD; Norio Hayashi, MD; Hideaki Tsukuma, MD
Acknowledgment: The authors thank the Osaka Cancer Registry for allowing use of their data and Ms. Yasue Kotani for assistance with statistical analysis.
Grant Support: By the Osaka Prefectural Government (1999–2000) and Grants-in-Aid for Hepatitis Research of the Japanese Ministry of Health, Labor, and Welfare.
Potential Financial Conflicts of Interest: None disclosed.
Reproducible Research Statement:Study protocol: Available by contacting Dr. Tanaka (e-mail, firstname.lastname@example.org). The protocol is only available in Japanese. Statistical code and data set: Not available.
Requests for Single Reprints: Hideo Tanaka, MD, 1-1 Kanokoden, Chikusa-ku Nagoya-shi, Aichi, Japan 464-8681; e-mail, email@example.com.
Current Author Addresses: Drs. Tanaka, Ito, Imanaka, and Tsukuma: 1-3-3 Nakamichi, Higashinari-ku, Osaka 537-8511, Japan.
Dr. Imai: 3-1-18 Johnan, Ikeda, Osaka 563-0025, Japan.
Drs. Hiramatsu and Takehara: 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
Dr. Oshita: 10-31 Kitayama-cho, Tennouji-ku, Osaka 543-0035, Japan.
Dr. Hijioka: 2-1 Kido-Higashi-cho, Kawashinagano, Osaka 586-0008, Japan.
Dr. Katayama: 4-2-78 Fukushima, Fukushima-ku, Osaka 553-0003, Japan.
Dr. Yabuuchi: 1-5-34 Otemae, Chuo-ku, Osaka 540-0008, Japan.
Dr. Yoshihara: 1179-3 Nagasone-cho, Kita-ku, Sakai, Osaka 591-8025, Japan.
Dr. Inoue: 3-1-56 Bandai-Higashi, Sumiyoshi-ku, Osaka 558-0056, Japan.
Dr. Kato: 2-1-14 Hoenzaka, Chuo-ku, Osaka 540-0006, Japan.
Dr. Tamura: 5-7-1 Kayano, Minoh, Osaka 562-0014, Japan.
Drs. Kasahara and Hayashi: 2-15 Yamadaoka, Suita, Osaka 565-0871, Japan.
Author Contributions: Concept and design: H. Tanaka, Y. Imai, N. Hiramatsu.
Analysis and interpretation of the data: Y. Imai, K. Imanaka, M. Oshita, T. Hijioka, K. Katayama, I. Yabuuchi, H. Yoshihara, A. Inoue, M. Kato, T. Takehara, S. Tamura, A. Kasahara, H. Tsukuma.
Drafting of the article: H. Tanaka.
Final approval of the article: H. Tanaka, Y. Imai, N. Hiramatsu, Y. Ito, K. Imanaka, M. Oshita, T. Hijioka, K. Katayama, I. Yabuuchi, H. Yoshihara, A. Inoue, M. Kato, T. Takehara, S. Tamura, A. Kasahara, N. Hayashi, H. Tsukuma.
Statistical expertise: Y. Ito.
Tanaka H, Imai Y, Hiramatsu N, Ito Y, Imanaka K, Oshita M, et al. Declining Incidence of Hepatocellular Carcinoma in Osaka, Japan, from 1990 to 2003. Ann Intern Med. 2008;148:820-826. doi: 10.7326/0003-4819-148-11-200806030-00004
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Published: Ann Intern Med. 2008;148(11):820-826.
Primary liver cancer was the fifth most common cancer worldwide by 2000, with approximately 551 000 new cases recorded (1). In most countries, hepatocellular carcinoma (HCC) comprises 85% to 90% of primary liver cancer cases. With some exceptions, developed countries, including the United States, have been experiencing an increase in the incidence of primary liver cancer, considered to be due at least in part to increased prevalence of chronic hepatitis C virus (HCV) infection (2).
Japan has had one of the highest incidence rates of primary liver cancer among developed countries (age-standardized incidence rate in 1995, 25.5 per 100 000 men and 7.7 per 100 000 women) (3). Approximately 90% of liver cancer cases are HCC, which, in Japan, is mainly caused by chronic HCV infection rather than chronic hepatitis B virus infection (4). A recent report on the age-standardized incidence of primary liver cancer among Japanese men, which was calculated from 6 population-based cancer registries, showed a sharp increase that started in the mid-1970s but leveled off in the mid-1990s (5). These distinctive trends were thought to be due to the spread of HCV infection, which began in the 1920s and increased after World War II (6–8). Thus, HCV penetrated Japan earlier than Spain, Egypt, the United States, the former Soviet Union, South Africa, and Hong Kong, as evidenced by molecular clock analysis of the sequences of HCV isolates (8). However, recent temporal trends regarding incidence rates of HCC and the contribution of HCV infection have not been clearly documented in the Japanese population.
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Gastroenterology/Hepatology, Hematology/Oncology, Infectious Disease, Liver Cancer, Gastrointestinal Cancer.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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