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. 2017 Jul 12;8(40):68131-68137.
doi: 10.18632/oncotarget.19245. eCollection 2017 Sep 15.

Age-specific sex difference in the incidence of hepatocellular carcinoma in the United States

Pian Liu  1 , Shao-Hua Xie  2 , Shaobo Hu  3 , Xiang Cheng  3 , Tianyi Gao  4 , Chen Zhang  3 , Zifang Song  3
Affiliations

Age-specific sex difference in the incidence of hepatocellular carcinoma in the United States

Pian Liu et al. Oncotarget. .

Abstract

Background: Hepatocellular carcinoma possesses a notable sex difference in incidence, and a protective role of estrogens has been hypothesized.

Methods: Using data from 13 cancer registries in the Surveillance, Epidemiology, and End Results Program, we describe the age-specific sex difference in the incidence of hepatocellular carcinoma in the United States during 1992-2013. We used a curve fitting by non-linear regression to quantitatively characterize the age-specific incidence rate of hepatocellular carcinoma by sex.

Results: A total of 44,287 incident cases of hepatocellular carcinoma (33,196 males and 11,091 females) were included, with an overall male-to-female ratio in age-standardized rate of 3.55. The sex ratio was below 2 at ages <25 years, increased with age from ages 25-29 years until peaking at 5.40 at ages 50-54 years, and declined thereafter. We also observed additional peaks in the age-specific sex ratio curves at ages 25-34 years across racial/ethnic groups. Modelling of age-specific incidence rates indicated a 15-year delayed increase with age in females compared with males in Asian and Pacific Islanders, and an 11-year delay in Hispanic whites.

Conclusions: The age-dependent patterns in the sex difference in the incidence of hepatocellular carcinoma support the hypothesis of a protective role of estrogens. The underlying reasons for the sex difference in hepatocellular carcinoma remain to be further explored in analytic epidemiological studies.

Keywords: estrogen; hepatocellular carcinoma; incidence; liver cancer; sex difference.

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Conflict of interest statement

CONFLICTS OF INTEREST The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1. Age-specific male-to-female ratio in the incidence of hepatocellular carcinoma by racial/ethnic group
Figure 2
Figure 2. Age-specific male-to-female ratio in the incidence of hepatocellular carcinoma by calendar period
Figure 3
Figure 3. Modelling of age-specific incidence rate (IR) of hepatocellular carcinoma by sex and racial/ethnic group
See this image and copyright information in PMC

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