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Liver cancer incidence statistics

Incidence statistics for liver cancer by country in the UK, age and trends over time are presented here. There are also data on lifetime risk, the distribution of cases, morphology, geography, socio-economic variation, and prevalence. The ICD code for liver cancer is ICD-10 C22. 

The latest incidence statistics available for liver cancer in the UK are 2010. Find out why these are the latest statistics available.

 

By country in the UK

Liver cancer is the 18th most common cancer in the UK (2010), accounting for 1% of all new cases. In males, it is the 14th most common cancer (2% of the male total), whilst it is the 19th in females (1%).1-4

In 2010, there were 4,241 new cases of liver cancer in the UK (Table 1.1): 2,672 (63%) in males and 1,569 (37%) in females, giving a male:female ratio of around 17:10.1-4 The crude incidence rate shows that there are 9 new liver cancer cases for every 100,000 males in the UK, and 5 for every 100,000 females.

In males, the European age-standardised incidence rate (AS rate) is significantly higher in Scotland than in England while it is significantly lower in Wales than in England and Scotland (Table 1.1).1-4 In females there are no significant differences between the countries of the UK. 

Table 1.1: Liver Cancer (C22), Number of New Cases, Crude and European Age-Standardised (AS) Incidence Rates per 100,000 Population, UK, 2010

England Wales Scotland Northern Ireland UK
Male Cases 2,231 113 269 59 2,672
Crude Rate 8.7 7.7 10.6 6.7 8.7
AS Rate 6.9 5.4 8.3 6.1 7.0
AS Rate - 95% LCL 6.6 4.4 7.3 4.5 6.7
AS Rate - 95% UCL 7.2 6.3 9.3 7.7 7.2
Female Cases 1,329 76 124 40 1,569
Crude Rate 5.0 4.9 4.6 4.4 5.0
AS Rate 3.2 2.7 3.0 3.4 3.1
AS Rate - 95% LCL 3.0 2.1 2.5 2.4 3.0
AS Rate - 95% UCL 3.3 3.4 3.5 4.5 3.3
Persons Cases 3,560 189 393 99 4,241
Crude Rate 6.8 6.3 7.5 5.5 6.8
AS Rate 4.9 4.0 5.4 4.6 4.9
AS Rate - 95% LCL 4.8 3.4 4.9 3.7 4.8
AS Rate - 95% UCL 5.1 4.6 5.9 5.5 5.1

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95% LCL and UCL are the 95% lower and upper confidence limits around the AS rate

There are no routinely available data on geographical variation of liver cancer incidence in regions of England. In Scotland, the highest rates are in Greater Glasgow & Clyde Health Board.5

section reviewed 29/10/13
section updated 29/10/13

 

By age

Liver cancer incidence is strongly related to age, with the highest incidence rates being in older men and women. In the UK between 2008 and 2010, an average of 70% of cases were diagnosed in men and women aged 65 years and over, and 93% were diagnosed in the 50s and over (Figure 1.1).1-4 Age-specific incidence rates rise from around age 40, steadily for women and more steeply for men, with the highest rates in the 85+ age group. 

Incidence rates are higher for males than for females, except for the under-25 and 30-34 age groups, when rates are similar between the sexes. The gap between male and female rates is highest between the ages of 55 and 59 when the male:female incidence ratio of age-specific rates (to account for the different proportions of males to females in each age group) is around 29:10 (Figure 1.1).1-4

Though rare, liver cancer can also occur in childhood with around one child in every million being diagnosed with the condition every year. 

Figure 1.1: Liver Cancer (C22), Average Number of New Cases per Year and Age-Specific Incidence Rates, UK, 2008-2010

cases_crude_liver.swf

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section reviewed 29/10/13
section updated 29/10/13

 

Trends over time

Liver cancer incidence rates have increased overall in Great Britain since the mid-1970s (Figure 1.2).1-3 For both males and females, European AS incidence rates increased by around three times between 1975-1977 and 2008-2010.

Much of this increase can probably be attributed to past changes in the prevalence of major risk factors for liver cancer, such as heavy alcohol consumption and infection with the hepatitis B and C viruses.6,7 Alcohol consumption increased in Britain during the 1990s, particularly in women, but the proportion of men and women drinking more than 21 and 14 units/week, respectively, has fallen since 2002.8 A corresponding fall in alcohol-related diseases, including liver cancer, might take a number of years to become apparent, due to the lag between alcohol consumption and related illness. For example, alcoholic liver disease takes approximately ten years to develop.9

Prevalence of infection with hepatitis B and C in the population of the UK over time is unknown, as no true random survey results exist.10 In the US, higher rates of hepatitis infection in the 1960s and 1970s (due to widespread intravenous drug use, sexual practices and unscreened blood transfusions) has been suggested as the main reason for increasing liver cancer rates.11

Figure 1.2: Liver Cancer (C22), European Age-Standardised Incidence Rates, Great Britain, 1975-2010

inc_asr_gb_liver.swf

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Liver cancer trends for the UK are shown in Figure 1.3.1-4 Over the last decade (between 1999-2001 and 2008-2010), European AS incidence rates have increased by 44% and 31% in males and females, respectively.

Figure 1.3:  Liver Cancer (C22), European Age-Standardised Incidence Rates, UK, 1993-2010

inc_asr_uk_liver.swf

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Liver cancer incidence rates have increased overall for all of the broad age groups in Great Britain since the mid-1970s (Figure 1.4).1-3 The largest increases have been in people aged 80+, with European AS incidence rates increasing by almost four times between 1975-1977 and 2008-2010.

Figure 1.4: Liver Cancer (C22), European Age-Standardised Incidence Rates, By Age, Great Britain, 1975-2010

inc_asr_age_p_liver.swf

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section reviewed 29/10/13
section updated 29/10/13

Lifetime risk

Lifetime risk is an estimation of the risk that a newborn child has of being diagnosed with cancer at some point during their life. It is a summary of risk in the population but genetic and lifestyle factors affect the risk of cancer and so the risk for every individual is different.

In 2010, in the UK, the lifetime risk of developing liver cancer is 1 in 120 for men and 1 in 215 for women.12

The lifetime risk for liver cancer has been calculated by the Statistical Information Team using the ‘Adjusted for Multiple Primaries’ (AMP) method; this accounts for the possibility that someone can have more than one diagnosis of liver cancer over the course of their lifetime.

section reviewed 25/04/13
section updated 25/04/13

Distribution of cases

Around half of all cases are liver cell cancers (51% in Great Britain between 2007 and 2009).1-3 These comprise liver cell carcinomas (ICD-10 C22.0), hepatoblastomas (ICD-10 C22.2), angiosarcomas of liver (ICD-10 C22.3), other sarcomas of liver (ICD-10 C22.4) and other specified carcinomas of liver (ICD-10 C22.7).13 Intrahepatic bile duct carcinomas (ICD-10 C22.1) make up a further 40% of the total, and the remaining 9% are of unspecified type.

Liver cell cancers  are more common than intrahepatic bile duct carcinomas in males (62% vs 30%, respectively), while intrahepatic bile duct carcinomas are the most common type in females (57% vs 33%, respectively).1-3

section reviewed 06/09/12
section updated 06/09/12

By morphology

The majority of liver cell cancers are hepatocellular carcinomas, while the majority of intrahepatic bile duct carcinomas are cholangiocarcinomas.13 There have been dramatic increases in the incidence of cholangiocarcinoma since the early 1970s (increasing 16-fold between 1971-1973 and 1999-2001 in England & Wales). Hepatocellular carcinoma incidence rates have also increased, but not by so much (around three-fold over the same time period). Some of the increase in cholangiocarcinoma incidence may be due to increased detection with new imaging techniques, such as computed tomography which became widely available in the mid-1980s; however this does not explain all of the rise.13 Similar increases in the incidence of intrahepatic cholangiocarcinoma and hepatocellular carcinoma have also been observed in the US between the mid-1970s and 1990s, both of which were thought to be real increases rather than as a result of increased detection.11,14

section reviewed 06/09/12
section updated 06/09/12

 

In Europe and worldwide

Although cancer registration has a long history in many countries of the world, particularly in the more affluent regions such as the UK, nearly 80% of the world’s populations live in regions that are not covered by such systems.15 Nonetheless, with a view to characterising the global burden of the disease, the International Agency for Research on Cancer routinely uses the available data to estimate worldwide cancer incidence.16

Liver cancer is the sixth most common cancer worldwide, with an estimated 750,000 new cases diagnosed in 2008 (6% of the total). Liver cancer incidence rates are highest in Eastern Asia and lowest in South-Central Asia and Northern Europe, with more than ten-fold variation in World AS incidence rates between the regions of the world in males, and around eight-fold variation in females (Figure 1.5).16

Figure 1.5: Liver Cancer (C22), World Age-Standardised Incidence Rates, World Regions, 2008 Estimates 

world_inc_liver.swf

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Global variation in the prevalence of risk factors for liver cancer explains most of the disparity in incidence between world regions. Worldwide, 77% of liver cancer cases in 2008 were linked to infections, with almost nine out of ten infection-related cases occurring in less developed regions.17 Consumption of foods contaminated with aflatoxin (produced by fungi which can contaminate foodstuffs such as maize and nuts in tropical or sub-tropical countries) is also an important risk factor in some less developed countries.18

Within the 27 countries of the European Union, the highest liver cancer European AS incidence rates for 2008 are estimated to be in Greece for both men and women (around 20 and 7 cases per 100,000, respectively); the lowest rates are estimated to be in The Netherlands for men (around 3 cases per 100,000) and Malta and Cyprus for women (around 1 case per 100,000) (Figure 1.6).19

Figure 1.6: Liver Cancer (C22), European Age-Standardised Incidence Rates, EU-27 Countries, 2008 Estimates 

EU27_inc_liver.swf

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UK liver cancer incidence rates are estimated to be the 11th and 14th lowest in males and females, respectively, in Europe (EU-27).19

section reviewed 06/09/12
section updated 06/09/12

 

By socio-economic variation

Liver cancer incidence is strongly related to deprivation and there is a clear trend of increasing rates with increasing levels of deprivation. The most recent England-wide data for 2000-2004 shows European AS incidence rates are around 83% higher for both men and women living in the most deprived areas compared with the least deprived. It has been estimated that there would have been 430 fewer liver cases each year in England during 2000-2004 if all men and women had experienced the same rates as the most affluent.20 A study in Scotland for 2005-2009 showed that the gap in liver cancer incidence by deprivation is even higher there, with rates for the most deprived men and women being more than twice those for the least deprived.5 Data for liver cancer incidence by socio-economic group are not routinely available for Wales and Northern Ireland.21,22 The higher incidence of liver cancer in more deprived populations can be partly attributed to differences in smoking prevalence, which is much higher in deprived groups compared with affluent in Great Britain.23

section reviewed 06/09/12
section updated 06/09/12

Prevalence

Prevalence refers to the number of people who have previously received a diagnosis of cancer and who are still alive at a given time point. Some patients will have been cured of their disease and others will not.

In the UK around 2,600 people were still alive at the end of 2006, up to ten years after being diagnosed with liver cancer (Table 1.2).24

Table 1.2: Liver Cancer (C22), One, Five and Ten Year Cancer Prevalence, UK, 31st December 2006

1 Year Prevalence 5 Year Prevalence 10 Year Prevalence
Male 709 1,380 1,727
Female 404 728 899
Persons 1,113 2,108 2,626

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Worldwide, it is estimated that there were more than 613,000 men and women still alive in 2008, up to five years after their diagnosis.15

section reviewed 17/05/13
section updated 17/05/13

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References for liver cancer incidence

  1. Data were provided by the Office for National Statistics on request, June 2012. Similar data can be found here: http://www.ons.gov.uk/ons/rel/vsob1/cancer-statistics-registrations--england--series-mb1-/index.html
  2. Data were provided by ISD Scotland on request, April 2012. Similar data can be found here: http://www.isdscotland.org/Health-Topics/Cancer/Publications/index.asp
  3. Data were provided by the Welsh Cancer Intelligence and Surveillance Unit on request, April 2012. Similar data can be found here: http://www.wales.nhs.uk/sites3/page.cfm?orgid=242&pid=59080
  4. Data were provided by the Northern Ireland Cancer Registry on request, October 2012. Similar data can be found here: http://www.qub.ac.uk/research-centres/nicr/CancerData/OnlineStatistics/
  5. ISD Scotland. Cancer statistics. Cancer of the liver and intrahepatic bile ducts: ICD-10 C22 Accessed April 2013.
  6. International Agency for Research on Cancer (IARC). World cancer report 2008 Lyon: IARC; 2008.
  7. Parkin DM, Boyd L, Walker LC. 16. The fraction of cancer attributable to lifestyle and environmental factors in the UK in 2010. Brit J C 2011;105 Suppl 2:S77-81.
  8. Office for National Statistics. Smoking and drinking among adults, 2009 report. 2011.
  9. Office for National Statistics. Statistical bulletin. Alcohol-related deaths in the United Kingdom, 2010. 2012. (PDF 121.8KB)
  10. Parkin DM. 11. Cancers attributable to infection in the UK in 2010. Brit J C 2011;105 Suppl 2:S49-56.
  11. El-Serag HB, Mason AC. Rising incidence of hepatocellular carcinoma in the United States. N Engl J Med 1999;340:745-50.
  12. Lifetime risk was calculated using 2010 data for males and 2008-2010 data for females by the Statistical Information Team at Cancer Research UK, 2012.
  13. West J, Wood H, Logan RF, et al. Trends in the incidence of primary liver and biliary tract cancers in England and Wales 1971-2001. Brit J C 2006;94:1751-8.
  14. Shaib YH, Davila JA, McGlynn K, et al. Rising incidence of intrahepatic cholangiocarcinoma in the United States: a true increase? J Hepatol 2004;40:472-7.
  15. Ferlay J, Shin HR, Bray F, et al. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J C 2010;127:2893-917.
  16. Ferlay J, Bray F, Forman D, et al. GLOBOCAN 2008 v1.2, Cancer incidence and mortality worldwide: IARC CancerBase No. 10 [Internet]. Lyon, France: International Agency for Research on Cancer; 2010. Available from http://globocan.iarc.fr. Accessed May 2011.
  17. de Martel C, Ferlay J, Franceschi S, et al. Global burden of cancers attributable to infections in 2008: a review and synthetic analysis. Lancet Oncol 2012.
  18. Chuang SC, La Vecchia C, Boffetta P. Liver cancer: descriptive epidemiology and risk factors other than HBV and HCV infection. Cancer Lett 2009;286:9-14.
  19. European Age-Standardised rates calculated by the Cancer Research UK Statistical Information Team, 2011, using data from GLOBOCAN 2008 v1.2, IARC, version 1.2. http://globocan.iarc.fr.
  20. National Cancer Intelligence Network Cancer incidence by deprivation England, 1995-2004. (PDF 1.04MB) 2008.
  21. Welsh Cancer Intelligence and Surveillance Unit. Cancer in Wales, 1995-2009: A comprehensive report. 2011.
  22. Donnelly DW, Gavin AT, Comber H. Cancer in Ireland 1994-2004: A comprehensive report. (PDF 7.77MB): Northern Ireland Cancer Registry/National Cancer Registry, Ireland; 2009.
  23. Office for National Statistics. General lifestyle survey overview. A report on the General Lifestyle Survey 2010 (PDF 1.31MB). 2012.
  24. National Cancer Intelligence Network (NCIN). One, five and ten-year cancer prevalence by cancer network, UK, 2006. London: NCIN; 2010.
Updated: 29 October 2013