Changes in survival patterns in urban Chinese patients with liver cancer

Aim: To examine the survival patterns and determinants of primary liver cancer in a geographically defined Chinese population. Methods: Primary liver cancer cases (n=l3 685) diagnosed between 1981 and 2000 were identified by the Tianjin Cancer Registry. Age-adjusted and age-specific incidence rates were examined in both males and females. Proportional hazards (Cox) regression was utilized to explore the effects of time of diagnosis, sex, age, occupation, residence, and hospital of diagnosis on survival. Results: Crude and age-adjusted incidence rates in the study period were: 27.4/100 000 and 26.3/100 000 in males; and 11.5/100 000 and 10.4/100 000 in females, respectively. Cox regression analyses indicated that there was a significant improvement in survival rates over time. Industrial workers and older people had relatively poor survival rates. The hospital in which the liver cancer was diagnosed was a statistically significant predictor of survival; patients diagnosed in city hospitals were more likely to have better survival than those diagnosed in community/district hospitals. Conclusion: Patients diagnosed in recent years appeared to have a better outcome than those diagnosed in early times. There were also significant survival disparities with respect to occupation and hospital of diagnosis, which suggest that socioeconomic status may play an important role in determining prognosis.