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Doubling of deaths from liver cancer in last 30 years

Increase in mortality rates from intrahepatic cholangiocarcinoma in England and Wales 2001; 48:816-20

Deaths from liver cancer have almost doubled in the past 30 years, shows research in Gut. A relatively rare type of liver cancer arising from the bile ducts-intrahepatic cholangiocarcinoma-accounts for virtually all of the increase.

The research team analysed deaths coded by liver tumour between 1968 and 1998, using national statistics for England and Wales. The information was assessed against expected death rates for a given age group per 100, 000 of the population.

Deaths from all types of liver tumour steadily increased over the period in both men and women, but the sharpest increase was seen in deaths from intrahepatic cholangiocarcinoma. In 1996 deaths from this tumour were 15 times higher than they were in 1968 in people aged 45 and older, rising from 38 to 736. By 1998, the totals had reached 864, with the sharpest rises seen among women. Intrahepatic cholangiocarcinoma is now the commonest cause of death from liver cancer in England and Wales, and has been since 1993.

The reasons for the increase are not immediately obvious, say the authors. Better diagnosis or diagnostic misclassification may be partially responsible, but they suggest that these factors are unlikely to account fully for the figures. Thorotrast, a now banned substance that used to be used in radiology, smoking and alcohol, and an increase in environmental oestrogen have all been linked to this type of tumour. But, say the authors, an increase in other environmental toxins may also have a role in the development of bile duct tumours.

Contact:

Dr Simon Taylor-Robinson, Liver Unit, Imperial College School of Medicine, London. s.taylor-robinson@ic.ac.uk

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