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Declining Incidence of Hepatocellular Carcinoma in Osaka, Japan, from 1990 to 2003

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; and Hideaki Tsukuma, MD
[+] Article and Author Information

From Osaka Medical Center for Cancer and Cardiovascular Diseases, Ikeda Municipal Hospital, Osaka University Graduate School of Medicine, Osaka Police Hospital, National Hospital Organization Osaka Minami Medical Center, Osaka Koseinenkin Hospital, Otemae Hospital, Osaka Rousai Hospital, Osaka General Medical Center, and National Hospital Organization Osaka National Hospital, Osaka, Japan.


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, hitanaka@aichi-cc.jp). 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, hitanaka@aichi-cc.jp.

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.


Ann Intern Med. 2008;148(11):820-826. doi:10.7326/0003-4819-148-11-200806030-00004
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The age-standardized incidence rate of HCC in men increased between 1981 and 1987 from 29.2 to 41.9 cases per 100 000 persons, then fluctuated until 1995. After that, it steadily decreased to 24.0 cases per 100 000 persons in 2003 (Figure 1). Among women, the age-standardized incidence rate of HCC increased between 1981 and 1996 from 6.6 to 10.8 cases per 100 000 persons, then gradually decreased to 7.3 cases per 100 000 persons in 2003 (Figure 1).

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Figure 1.
Trends in age-standardized (world population) incidence of hepatocellular carcinoma in Osaka, Japan, 1981–2003.
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Figure 2.
Joinpoint analysis of the incidence rate of hepatocellular carcinoma among individuals age 50 to 79 years in Osaka, Japan, 1981–2003.
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Figure 3.
Trends in estimated incidence rates of hepatitis C virus (HCV)–related and non–HCV-related hepatocellular carcinoma (HCC) in Osaka, Japan, 1990–2003.

Information on anti-HCV status only became available after 1989. Error bars indicate 95% CIs.

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