Rising Incidence of Primary Liver Cancer in Brunei Darussalam

  • Published : 2013.06.30


Background: Primary liver cancer (PLC) is the fifth most common malignancy worldwide and is still associated with high mortality. Hepatocellular carcinoma (HCC) and cholangiocarcinoma are the two most common PLCs, and their incidence varies across regions. Currently there are no published data available on the incidence of PLC in Brunei Darussalam. Materials and Methods: All proven PLCs between 2000 and 2009 were identified from the National Cancer Registry and reviewed. Metastatic diseases were excluded. A total of 123 cases (male 65.8%, female 34.2%) were identified and their data collected for calculation of the age standardised rate (ASR). Results: The most common type of PLC was HCC (87.8%) followed by cholangiocarcinoma (10.6%). There were two cases of hepatoblastoma. The mean age at diagnosis was 63.2 years. The overall ASR of PLC was 8.2/100,000, increasing from 4.5/100,000 population in 2000 to 11.4/100,000 population in 2009. The rates were higher among males (12.0/100,000) than females (4.7/100,000). Among the ethnic groups, Chinese had the highest rates (overall 13.1/100,000 with none recorded in 2000 to 30.3/100,000 in 2009) compared to the Malays (overall 8.5/100,000 increasing from 4.5/100,000 in 2000 to 12.3/100,000 in 2009) and the indigenous groups. The incidence increased after the age of 50 and was highest among the 75-79 age groups. Increase was seen for HCC but not for cholangiocarcinoma. Conclusions: The most common type of PLC is HCC and the annual incidence of PLC is increasing in Brunei Darussalam,rates being higher in males and Chinese.


  1. Ahmad OB, Boschi-Pinto C, Lopez AD, et al (2001). Age standardization of rates: a new who standard', GPE Discussion Paper Series: No.31, no. EIP/GPE/EBD World Health Organization 2001.
  2. Alexander MJ, Sinnatamby AS, Rohaimah MJ, et al (1990). Incidence of hepatitis B infection in Brunei Darussalamanalysis of racial distribution. Ann Acad Med Singapore, 19, 344-6.
  3. Amon JJ, Nedsuwan S, Chantra S, et al (2006). Trends in liver cancer, Sa Kaeo Province Thailand. Asian Pac J Cancer Prev, 6, 382-6.
  4. Cancer research UK. Liver cancer incidence statistics 2010. Available from (Accessed 6th December 2012).
  5. Chen JG, Zhang SW (2011). Liver cancer epidemic in China: past, present and future. Semin Cancer Biol, 21, 59-69.
  6. Chong VH, Abdullah MS, Telisinghe PU, et al (2009). Colorectal cancer: incidence and trend in Brunei Darussalam. Singapore Med J, 50, 1085-9.
  7. Faivre J, Forman D, Esteve J, et al (1998). Survival of patients with primary liver cancer, pancreatic cancer and biliary tract cancer in Europe. Euro J Cancer, 34, 2184-90.
  8. International Agency for Research on Cancer. GLOBOCAN 2008 Fact Stats. Available from (Accessed 14th February 2013).
  9. Kamsa-ard S, Wiangnon S, Suwanrungruang K, et al (2011). Trends in liver cancer incidence between 1985 and 2009, Khon Kean, Thailand: cholangiocarcinoma. Asian Pac J Cancer Prev, 12, 2209-13.
  10. National Cancer Registry Report. Malaysia Cancer Statistics-Data and Figure 2007. Available from (Accessed 6th December 2012).
  11. Pathy NB, Yip CH, Taib NA, et al (2011). Breast cancer in a multi-ethnic Asian setting: results from the Singapore-Malaysia hospital-based breast cancer registry. Breast, 20, 75-80.
  12. Sebastian VJ, Bhattacharya S, Ray S, et al (1989). Hepatitis-B surface antigen and VDRL in healthy blood donors of Brunei Darussalam. Singapore Med J, 30, 568-70.
  13. Singapore Cancer Registry Interim Annual registry Report. Trends in cancer incidence in Singapore 2006-2010. Available from (Accessed 6th December 2012).
  14. Srivatanakul P, Sriplug H, Deerasamee S (2004). Epidemiology of liver cancer: an overview. Asia Pac J Cancer Prev, 5, 118-25.
  15. Teo KS, Saparudin MS, Zaini Z, et al (2011). Transfusion transmissible infections in Brunei Darussalam: a blood donor study. Brunei Int Med J, 7, 321-7.
  16. Tsukuma H, Tanaka H, Ajiki W, et al (2005). Liver cancer and its prevention. Asia Pac J Cancer Prev, 6, 244-50.
  17. Wang H, Seow A, Lee HP (2004). Trends in cancer incidence among Singapore Malays: a low-risk population. Ann Acad Med Singapore, 33, 57-62.
  18. World Health Organization: WHO (2013). Cancer Fact Sheet N*297 Reviewed January 2013. Available from (Accessed 14th February 2013).

Cited by

  1. Overview of Cancer Registration Research in the Asian Pacific from 2008-2013 vol.14, pp.8, 2013,
  2. Analysis of Different Ways of Drainage for Obstructive Jaundice Caused by Hilar Cholangiocarcinoma vol.15, pp.14, 2014,
  3. Cancers of the Young Population in Brunei Darussalam vol.15, pp.15, 2014,
  4. Prognostic Value of Serum AFP, AFP-L3, and GP73 in Monitoring Short-term Treatment Response and Recurrence of Hepatocellular Carcinoma after Radiofrequency Ablation vol.15, pp.4, 2014,
  5. The prognostic values of 12 cirrhosis-relative noninvasive models in patients with hepatocellular carcinoma vol.75, pp.1, 2015,
  6. Prognostic value of the combination of serum levels of vascular endothelial growth factor, C-reactive protein and contrast-enhanced ultrasound in patients with primary liver cancer who underwent transcatheter arterial chemoembolization vol.17, pp.12, 2017,
  7. The Prognostic Value of Platelet Count in Patients With Hepatocellular Carcinoma vol.94, pp.37, 2015,
  8. Current Status and Future Prospects of Biomarkers in the Diagnosis of Hepatocellular Carcinoma vol.32, pp.4, 2017,