OBJECTIVETo analyze the patterns and changes of liver cancer mortality in China.

METHODSData of national retrospective sampling survey for the years of 2004 - 2005 from 158 counties/cities/districts was used for the settings, covering a 2-year's population of 142 660 482 person years, in which 47 899 806 in urban areas, and 94 760 676 in rural areas. Furthermore, the areas of Eastern, Central, and Western were divided into the subsets, with populations of 52 556 694, 49 781 225 and 40 322 563 person years, respectively. The crude rate (CR) and the age-standardized rate by Chinese population of 1982 (CASR) and by world's population of 1985 (WASR) were calculated. The historical comparisons with the national survey data of 1973 - 1975 (First time) and with the sampling survey of 1990 - 1992 (Second time) were made, and the global comparisons with some selected countries were performed.

RESULTSA total of 37 645 death cases with liver cancer were recorded from the 158 samples in the year 2004 - 2005, with the CR of 26.26 per 100 000 (males: 27 398 cases, 37.55 per 100 000, and females: 10 067 cases, 14.45 per 100 000), which ranked the second after lung cancer, accounted for 19.33% of all sites of cancers (37 465/193 841). 93.04% of the sampling districts (147/158) showed the CRs amongst 10.00 to 39.00 per 100 000. The CASR was 17.86 per 100 000 (males: 26.44, females: 9.20), and the WASR was 23.48 per 100 000 (males: 34.61, females: 12.34). In the urban areas, the CR of liver cancer was 24.94 per 100 000 (11 945 cases, CASR: 15.34), and 26.93 per 100 000 (25 520 cases, CASR: 19.32) in the rural areas. The sex ratio of the male to female mortality rate was 2.60:1 (2.68:1 in urban areas, and 2.56:1 in rural areas). The death cases in the Eastern, Central, and Western areas were 14 909, 13 349 and 9 207, with CRs of 28.37, 26.82, and 22.83 per 100 000, respectively. The CR was increased by 89.77% compared with the data from the First time (1973 - 1975: 10.75 per 100 000), and increased by 28.73% compared with the data of the Second time (1990 - 1992: 20.37 per 100 000). In addition, the CR from 12.42 (the First) increased to 19.50 per 100 000 (the Second) in the urban areas, and from 10.12 (the First) increased to 20.67 per 100 000 (the Second) in the rural areas. Global comparison showed that the CR for the liver cancer in China ranked the sixth for men, and fifth for women; and it ranked the ninth, and seventh according to the WASR amongst the top-rate countries.

CONCLUSIONLiver cancer is the second leading site of cancer death-cause in China. The CR has been rising, while the trend for the standardized rate is not so apparent. Control of the liver cancer should be still the priority of all anti-cancer activities in China.