Tan Darren Jun Hao, Setiawan Veronica Wendy, Ng Cheng Han, Lim Wen Hui, Muthiah Mark D, Tan Eunice X, Dan Yock Young, Roberts Lewis R, Loomba Rohit, Huang Daniel Q
Yong Loo Lin School of Medicine , National University of Singapore , Singapore.
Department of Population and Public Health Sciences, Keck School of Medicine , University of Southern California , Los Angeles , California , USA.
Hepatology. 2023 Apr 1;77(4):1150-1163. doi: 10.1002/hep.32758. Epub 2022 Sep 12.
The etiology of liver diseases has changed in recent years, but its impact on the comparative burden of liver cancer between males and females is unclear. We estimated sex differences in the burden of liver cancer across 204 countries and territories from 2010 to 2019.
We analyzed temporal trends in the burden of liver cancer using the methodology framework of the 2019 Global Burden of Disease study. We estimated annual frequencies and age-standardized rates (ASRs) of liver cancer incidence, death, and disability-adjusted life-years (DALYs) by sex, country, region, and etiology of liver disease. Globally in 2019, the frequency of incident cases, deaths, and DALYs due to liver cancer were 376,483, 333,672, and 9,048,723 in males, versus 157,881, 150,904, and 3,479,699 in females. From 2010 to 2019, the incidence ASRs in males increased while death and DALY ASRs remained stable; incidence, death, and DALY ASRs in females decreased. Death ASRs for both sexes increased only in the Americas and remained stable or declined in remaining regions. In 2019, hepatitis B was the leading cause of liver cancer death in males, and hepatitis C in females. From 2010 to 2019, NASH had the fastest growing death ASRs in males and females. The ratio of female-to-male death ASRs in 2019 was lowest in hepatitis B (0.2) and highest in NASH (0.9).
The overall burden of liver cancer is higher in males, although incidence and death ASRs from NASH-associated liver cancer in females approach that of males.
近年来肝脏疾病的病因发生了变化，但其对男性和女性肝癌相对负担的影响尚不清楚。我们估算了2010年至2019年期间204个国家和地区肝癌负担的性别差异。
我们使用2019年全球疾病负担研究的方法框架分析了肝癌负担的时间趋势。我们按性别、国家、地区和肝脏疾病病因估算了肝癌发病率、死亡率和伤残调整生命年（DALY）的年度发生率和年龄标准化率（ASR）。2019年全球范围内，男性因肝癌导致的发病病例、死亡和DALY的发生率分别为376,483、333,672和9,048,723，而女性分别为157,881、150,904和3,479,699。2010年至2019年期间，男性的发病率ASR上升，而死亡率和DALY的ASR保持稳定；女性的发病率、死亡率和DALY的ASR下降。仅在美洲，两性的死亡率ASR均有所上升，在其他地区则保持稳定或下降。2019年，乙型肝炎是男性肝癌死亡的主要原因，丙型肝炎是女性肝癌死亡的主要原因。2010年至2019年期间，非酒精性脂肪性肝炎（NASH）在男性和女性中的死亡率ASR增长最快。2019年，女性与男性死亡率ASR之比在乙型肝炎中最低（0.2），在NASH中最高（0.9）。
肝癌的总体负担在男性中更高，尽管女性中与NASH相关的肝癌的发病率和死亡率ASR接近男性。
