The incidence of hepatocellular carcinoma (HCC) in Japan is still increasing. The aim of the present study was to analyze the epidemiological trend of HCC in the Western area of Japan, Nagasaki. A total of 1,807 patients with HCC diagnosed at our two hospitals between 1981 and 2005 were consecutively recruited for this study. Cohorts of patients with HCC were categorized into five-year intervals. The etiology of HCC was categorized into four groups: HCC-B: HBsAg positive, HCVAb negative, HCC-C: HCVAb positive, HBsAg negative, HCC-BC: both of HBsAg and HCVAb positive and HCC-nonBC: both of HBsAg and HCVAb negative. The number and proportion of HCC-B cases decreased from 1986 to 1990 and thereafter stabilized, whereas those of HCC-C reached the peak from 1995 to 2000 and thereafter decreased. On the other hand, the number and ratio of the HCC-nonBC cases continued to increase in the whole period. The male/female ratio of HCC-C patients decreased from 6.4 in the period 1981-1985 to 1.9 in 2001-2005, indicating clearly the increase of female patients. On the other hand, the male/female ratio of other types of HCC patients did not change during the period. HCC patients rapidly increased from 1981 to 2000 and this increase was originated from that of HCC-C. The increase of the median age and the number of female patients with HCC-C was also demonstrated. The increase in the number and the proportion of the HCC-nonBC patients was also significant.

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