Hepatocellular carcinoma incidence at national and provincial levels in Iran from 2000 to 2016: A meta-regression analysis

Abstract

Background The incidence of Hepatocellular carcinoma (HCC), the most common primary liver cancer with high mortality, is undergoing global change due to evolving risk factor profiles. We aimed to describe the epidemiologic incidence of HCC in Iran by sex, age, and geographical distribution from 2000 to 2016. Methods We used the Iran Cancer Registry to extract cancer incidence data and applied several statistical procedures to overcome the dataset’s incompleteness and misclassifications. Using Spatio-temporal and random intercept mixed effect models, we imputed missing values for cancer incidence by sex, age, province, and year. Besides, we addressed case duplicates and geographical misalignments in the data. Results Age-standardized incidence rate (ASIR) increased 1.17 times from 0.57 (95% UI: 0.37–0.78) per 100,000 population in 2000 to 0.67 (0.50–0.85) in 2016. It had a 21.8% total percentage change increase during this time, with a 1.28 annual percentage change in both sexes. Male to female ASIR ratio was 1.51 in 2000 and 1.57 in 2016. Overall, after the age of 50 years, HCC incidence increased dramatically with age and increased from 1.19 (0.98–1.40) in the 50–55 age group to 6.65 (5.45–7.78) in the >85 age group. The geographical distribution of this cancer was higher in the central, southern, and southwestern regions of Iran. Conclusion The HCC incidence rate increased from 2000 to 2016, with a more significant increase in subgroups such as men, individuals over 50 years of age, and the central, southern, and southwestern regions of the country. We recommend health planners and policymakers to adopt more preventive and screening strategies for high-risk populations and provinces in Iran.