THE DESCRIPTIVE EPIDEMIOLOGY OF PRIMARY LIVER-CANCER IN ITALY

Using figures from the official death registry, we studied the descriptive epidemiology of primary liver cancer (PLC) in Italy from 1969 to 1985. The annual age-standardized mortality rate rose from 3.7/100,000 in 1969 to 4.7/100,000 in 1985, reaching the peak of 6.5/100,000 in 1983. The male/female ratio increased from 1.2:1 in 1969 to 2:1 in 1985. The age-specific mortality rate was very low in subjects under 55 years of age and peaked in subjects in their seventies and eighties. The rate was higher for men in all age-groups. The highest proportion of deaths (32%) was observed in the 65-74 year age group. The median age of death for patients with PLC was 10 years older than the median age for patients who died of alcoholic liver cirrhosis, but similar to that of patients who died of liver cirrhosis due to other causes. The highest regional age-standardized mortality rate was reported in Lombardia, Lazio and Veneto respectively, where hepatitis B virus (HBV) infection is less endemic than in the southern regions and the Islands. It should be kept in mind that these findings are not extremely accurate because they are based on mortality figures, where the contamination with metastatic cases is practically unavoidable; furthermore, their validity and comparability are not first-rate due to the wide variation in diagnostic accuracy and registration completeness. However, certain epidemiologic features are evident: the increasing mortality trend over time, the higher occurrence among males and older age groups, and the lag time of 10 years in the median age of death for patients with HCC as compared to that of patients with alcoholic liver cirrhosis.