Rising Incidence of Primary Liver Cancer in Brunei Darussalam Raymond

Cancers remain one of the world’s greatest disease burdens and cause of death. In 2008, 12.7 million new cancer cases and 7.6 million cancer related deaths were recorded (Globocan, 2008; WHO, 2013). Cancers related deaths accounted for 13% of all recorded deaths. Among all the cancers, lung cancer is the most common cause of cancer deaths, followed by stomach cancer and liver cancer. Worldwide, PLC is the fifth most common cancer in men (523,000 cases, 7.9% of the total) and the seventh in women (226,000 cases, 6.5% of the total) with 85% occurring in developing countries (Globocan, 2008). Generally, men are more affected with a ratio of 2.4 to women. Hepatocellular carcinoma (HCC) is the most common type and accounts for up to 85% of all PLC (Amon et al., 2006). The rates are highest in Eastern and South-Eastern Asia, Middle and Western Africa, but also Melanesia and Micronesia/Polynesia (particularly in men) and generally low in developed countries especially North America and Europe (Srivatanakul et al., 2004). In 2008, an estimated 694,000 deaths from liver cancer (477,000