Hepatocellular carcinoma (HCC) is cancer that starts in the liver and is the sixth most common cancer worldwide. Major risk factors include hepatitis B virus (HBV) infection, hepatitis C virus (HCV) infection and excessive alcohol intake.  Among the eight major pharmaceutical markets (8MM: US, France, Germany, Italy, Spain, UK, Japan, urban China), the Asia-Pacific markets of Japan and urban China have a markedly higher burden of HCC compared to the remaining 8MM.

By the end of 2020, the diagnosed incidence of HCC in urban China is expected to be approximately 25 cases per 100,000 population, while the diagnosed incidence of HCC in Japan is expected to be nearly 30 cases per 100,000 population (as shown in Figure 1). This is roughly 30,000 new cases and 160,000 new cases in Japan and urban China, respectively. In the remaining markets combined, the average diagnosed incidence is only about 15 cases per 100,000 population or 75,000 new cases. This positions urban China and Japan with an incidence of over 1.5 to two times higher than the remaining markets, and even more striking, these two markets combined represent over 70% of total new HCC cases occurring in the 8MM.

What is driving the high incidence of HCC in areas of the Asia-Pacific such as Japan and urban China? GlobalData epidemiologists believe this is likely due to two things: one, the distribution of HCC risk factors in both Japan and urban China, with a higher prevalence of HCV and HBV compared with the remaining 8MM; and two, the ageing populations of both countries. More specifically, HCV is the predominant risk factor of HCC in Japan, whereas HBV is the predominant risk factor of HCC in urban China, accounting for nearly half to three-quarters of new cases in Japan and urban China (as shown in Figure 2). To help alleviate the burden of HCC in Japan and urban China, future prevention efforts and strategies should be aimed at lowering the prevalence of major HCC risk factors. National public health agencies should continue to focus on providing timely vaccinations against HBV and aim to identify and initiate treatment early on in individuals with HBV/HCV.

Figure 1: 8MM, Diagnosed Incidence of Hepatocellular Carcinoma in 2020, Both Sexes, Ages ≥18 Years (Cases per 100,000 Population).

Source: GlobalData.

Figure 2: 8MM, Proportion of Diagnosed Incident Cases of Hepatocellular Carcinoma with Hepatitis B and Hepatitis C Infection in 2020, Both Sexes, Ages ≥18 Years (%).

Source: GlobalData.