Rising Incidence of Primary Liver Cancer in Brunei Darussalam


Background: Primary liver cancer (PLC) is the fifth most common malignancy worldwide and is still associatedwith high mortality. Hepatocellular carcinoma (HCC) and cholangiocarcinoma are the two most common PLCs,and their incidence varies across regions. Currently there are no published data available on the incidence ofPLC in Brunei Darussalam. Materials and
Methods: All proven PLCs between 2000 and 2009 were identifiedfrom the National Cancer Registry and reviewed. Metastatic diseases were excluded. A total of 123 cases (male65.8%, female 34.2%) were identified and their data collected for calculation of the age standardised rate(ASR).
Results: The most common type of PLC was HCC (87.8%) followed by cholangiocarcinoma (10.6%).There were two cases of hepatoblastoma. The mean age at diagnosis was 63.2 years. The overall ASR of PLCwas 8.2/100,000, increasing from 4.5/100,000 population in 2000 to 11.4/100,000 population in 2009. The rateswere higher among males (12.0/100,000) than females (4.7/100,000). Among the ethnic groups, Chinese had thehighest rates (overall 13.1/100,000 with none recorded in 2000 to 30.3/100,000 in 2009) compared to the Malays(overall 8.5/100,000 increasing from 4.5/100,000 in 2000 to 12.3/100,000 in 2009) and the indigenous groups. Theincidence increased after the age of 50 and was highest among the 75-79 age groups. Increase was seen for HCCbut not for cholangiocarcinoma.
Conclusions: The most common type of PLC is HCC and the annual incidenceof PLC is increasing in Brunei Darussalam,rates being higher in males and Chinese.