Long-Term Trend of Liver Cancer Mortality in Serbia, 1991–2015: An Age-Period-Cohort and Joinpoint Regression Analysis

Abstract

Background and Objectives: Trends of liver cancer mortality vary widely around the world. The purpose of this study was to assess the trend of liver cancer mortality in Serbia. Material and Methods: Descriptive epidemiological study design was used in this research. The age-standardized rates (ASRs, per 100,000) were calculated using the direct method, according to the World standard population. Temporal trends were assessed using the average annual percent change (AAPC) with 95% confidence interval (95% CI), according to joinpoint regression. An age-period-cohort analysis was used to evaluate the underlying factors for liver cancer mortality trends. Results: In Serbia from 1991 to 2015, over 11,000 men and nearly 8000 women died from liver cancer. The trend in liver cancer mortality significantly decreased both in men (AAPC = −1.3%; 95% CI = −1.7 to −0.9) and women (AAPC = −1.5%; 95% CI = −1.9 to −1.1). For liver cancer mortality, statistically significant cohort and period effects were observed in both genders. Conclusions: The downward trends in liver cancer mortality in Serbia are recorded during the past decades.

Keywords

• liver cancer
• mortality
• trends
• joinpoint regression analysis
• age-period-cohort analysis