Global trajectories of liver cancer burden from 1990 to 2019 and projection to 2035

作     者：Fan Yang Dianqin Sun Changfa Xia He Li Maomao Cao Xinxin Yan Siyi He Shaoli Zhang Wanqing Chen 

作者机构：Office of Cancer ScreeningNational Cancer CenterNational Clinical Research Center for CancerCancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China 

出 版 物：《Chinese Medical Journal》 (中华医学杂志（英文版）)

年 卷 期：2023年第136卷第12期

页      面：1413-1421页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

基　　金：National Natural Science Foundation of China(Nos.82273721,81974492) Sanming Project of Medicine in Shenzhen(No.SZSM201911015) 

主　　题：Global liver cancer Long-term trajectories Risk factors 

摘      要：Background:Large disparities exist in liver cancer burden trends across countries but are poorly understood.We aimed to investigate the global trajectories of liver cancer burden,explore the driving forces,and predict future trends.Methods:Data on the liver cancer burden in 204 countries and territories from 1990 to 2019 were extracted from the Global Burden of Disease Study.The age-standardized incidence rate(ASIR)and age-standardized mortality rate(ASMR)trajectories were defined using growth mixture models.Five major risk factors contributing to changes in the ASIR or ASMR and socioeconomic determinants were explored using the identified trajectories.A Bayesian age-period-cohort model was used to predict future trends through 2035.Results:Three trajectories of liver cancer burden were identified:increasing,stable,and decreasing groups.Almost half of the American countries were classified in the decreasing group(48.6%for ASIR and ASMR),and the increasing group was the most common in the European region(ASIR,49.1%;ASMR,37.7%).In the decreasing group,the decrease of liver cancer due to hepatitis B contributed 63.4%and 60.4%of the total decreases in ASIR and ASMR,respectively.The increase of liver cancer due to alcohol use,hepatitis C,and hepatitis B contributed the most to the increase in the increasing group(30.8%,31.1%,and 24.2%for ASIR;33.7%,30.2%,and 22.2%for ASMR,respectively).The increasing group was associated with a higher sociodemographic index,gross domestic product per capita,health expenditure per capita,and universal health coverage(all P0.05).Significant variations in disease burden are predicted to continue through 2035,with a disproportionate burden in the decreasing group.Conclusion:Global disparities were observed in liver cancer burden trajectories.Hepatitis B,alcohol use,and hepatitis C were identified as driving forces in different regions.