Department of Hepatology, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, Fujian Province, China.
Department of Statistics, Xiamen University, Xiamen 361000, Fujian Province, China.
World J Gastroenterol. 2022 Jun 7;28(21):2361-2382. doi: 10.3748/wjg.v28.i21.2361.
Primary liver cancer (PLC) is a major contributor to cancer-related deaths. Data on global and country-specific levels and trends of PLC are essential for understanding the effects of this disease and helping policymakers to allocate resources.
To investigate the association between the burden of PLC and socioeconomic development status.
Cancer mortality and incidence rates were obtained from the Global Burden of Disease (GBD) 2019, and the data were stratified by country and territory, sex, and the Socio-demographic Index (SDI) level. The association between the attributable etiology of PLC and socioeconomic development status, represented using the SDI, was described. The attributable etiology of PLC included hepatitis B, hepatitis C, alcohol use, and nonalcoholic steatohepatitis. The association between the attributable etiology of PLC and SDI was further stratified by sex and geographical location. A confidence analysis was also performed based on bootstrap draw.
The age-standardized incidence rate of PLC was 6.5 [95% confidence intervals (CI): 5.9-7.2] per 100000 person-years, which decreased by -27.5% (-37.0 to -16.6) from 1990 to 2019. Several countries located in East Asia, South Asia, West Africa, and North Africa shouldered the heaviest burden of PLC in 2019. In terms of incidence rates, the first leading underlying cause of PLC identified was hepatitis B, followed by hepatitis C, alcohol use, and nonalcoholic steatohepatitis. Regarding stratification using the SDI, the incidence rate of PLC was the highest for high and middle SDI locations. Further, the leading attributable etiologies of PLC were hepatitis B for the middle and high middle SDI locations while hepatitis C and nonalcoholic steatohepatitis for the high SDI locations.
The pronounced association between socioeconomic development status and PLC burden indicates socioeconomic development status affects attributable etiologies for PLC. GBD 2019 data are valuable for policymakers implementing PLC cost-effective interventions.
原发性肝癌（PLC）是癌症相关死亡的主要原因。了解全球和特定国家/地区 PLC 的水平和趋势的数据对于了解这种疾病的影响并帮助决策者分配资源至关重要。
探讨 PLC 负担与社会经济发展状况之间的关系。
从全球疾病负担（GBD）2019 中获取癌症死亡率和发病率数据，并按国家/地区、性别和社会人口指数（SDI）水平进行分层。描述了 PLC 的可归因病因与代表社会经济发展状况的 SDI 之间的关系。PLC 的可归因病因包括乙型肝炎、丙型肝炎、饮酒和非酒精性脂肪性肝炎。还按性别和地理位置对 PLC 的可归因病因与 SDI 之间的关系进行了分层。还根据引导抽样进行了置信度分析。
PLC 的年龄标准化发病率为 6.5 [95%置信区间（CI）：5.9-7.2] / 100000 人年，1990 年至 2019 年下降了 27.5%（-37.0 至-16.6）。2019 年，东亚、南亚、西非和北非的几个国家承担了 PLC 的最大负担。在发病率方面，PLC 的首要潜在病因是乙型肝炎，其次是丙型肝炎、饮酒和非酒精性脂肪性肝炎。关于使用 SDI 进行分层，PLC 的发病率在高和中 SDI 地区最高。此外，PLC 的主要可归因病因是乙型肝炎在中高 SDI 地区，丙型肝炎和非酒精性脂肪性肝炎在高 SDI 地区。
社会经济发展状况与 PLC 负担之间的显著关联表明，社会经济发展状况影响 PLC 的可归因病因。GBD 2019 数据对于实施 PLC 具有成本效益的干预措施的决策者具有价值。
