Incidence, Mortality, and Survival Trends of Liver Cancer in the Canton of Zurich, Switzerland, Between 1980 and 2022
Nina Zuber, Flurina Suter, Miriam Wanner, Dimitri Korol, Sabine RohrmannABSTRACT
Background
The global burden of liver cancer has been increasing over recent decades, whereas the incidence in Switzerland has remained relatively stable. This study assessed long‐term trends in incidence, mortality, and 1‐ and 5‐year relative survival of primary liver cancer in the Swiss canton of Zurich from 1980 to 2022, stratified by sex and age.
Methods
This population‐based retrospective analysis included all primary liver cancer cases diagnosed in the canton of Zurich and registered in the Cancer Registry of the cantons of Zurich, Zug, Schaffhausen and Schwyz between 1980 and 2022. Mortality data were obtained from the Federal Statistical Office. Cases were classified according to ICD‐O‐3 topography and morphology and, from 2003 onward, TNM stage. Age‐standardised incidence and mortality rates were calculated using the 1976 European standard population. Temporal trends were analysed using Joinpoint regression and reported as Average Annual Percentage Changes (AAPCs) with 95% confidence intervals (CIs). Relative survival was estimated using the Ederer II method and standardised according to international standards.
Results
Among 3866 incident cases, 71.3% were hepatocellular carcinomas and 70.7% occurred in men. Overall age‐standardised incidence remained stable in both men (AAPC −0.1%, 95% CI −0.6 to 0.3%) and women (−0.2%, −0.9% to 0.4%). However, incidence increased significantly among individuals younger than 65 years, particularly in women (AAPC 2.3%, 1.3%–3.3%) and men (1.2%, 0.6%–1.9%). Mortality remained broadly stable in men and increased modestly in women. One‐ and five‐year relative survival improved substantially, from 13.8% and 3.5% in 1980–1999 to 53.9% and 25.8% in 2016–2022, respectively. Improvements were greater in men than women.
Conclusion
These findings reflect major advances in liver cancer diagnosis and treatment over the past four decades. Continued prevention, targeted screening of high‐risk groups, and epidemiological monitoring remain important.