Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
Cancer Biol Med. 2024 Jul 16;21(8):679-91. doi: 10.20892/j.issn.2095-3941.2024.0149.
Liver cancer is a major health concern globally and in China. This analysis investigated deaths and disability-adjusted life years (DALYs) with respect to etiologies and risk factors for liver cancer in China and worldwide.
Global and China-specific data were collected on liver cancer deaths, DALYs, and age-standardized rates (ASRs) from the Global Burden of Disease Study 2019 database. Liver cancer etiologies were classified into five groups and risk factors were categorized into three levels. Each proportion of liver cancer burden was calculated in different geographic regions. The joinpoint regression model were used to assess the trends from 1990-2019.
Liver cancer accounted for 484,577 deaths worldwide in 2019 with an ASR of 5.9 per 100,000 population. China had an elevated liver cancer death ASR in 2019 and males had an ASR 1.7 times the global rate. The global ASR for DALYs peaked at 75-79 years of age but peaked earlier in China. Hepatitis B virus was the prominent etiology globally (39.5%) and in China (62.5%), followed by hepatitis C virus and alcohol consumption. In high sociodemographic index countries, non-alcoholic steatohepatitis has gained an increasing contribution as an etiologic factor. The liver cancer burden due to various etiologies has decreased globally in both genders. However, metabolic risk factors, particularly obesity, have had a growing contribution to the liver cancer burden, especially among males.
Despite an overall decreasing trend in the liver cancer burden in China and worldwide, there has been a rising contribution from metabolic risk factors, highlighting the importance of implementing targeted prevention and control strategies that address regional and gender disparities.
肝癌是全球和中国的一个主要健康问题。本分析研究了中国和全球肝癌病因和危险因素导致的死亡和伤残调整生命年（DALY）。
从全球疾病负担研究 2019 年数据库中收集了全球和中国特定的肝癌死亡、DALY 和年龄标准化率（ASR）数据。肝癌病因分为五组，危险因素分为三个层次。在不同地理区域计算了肝癌负担的各个比例。使用 joinpoint 回归模型评估了 1990 年至 2019 年的趋势。
2019 年全球肝癌死亡 484577 例，ASR 为每 10 万人 5.9 例。2019 年中国肝癌死亡 ASR 较高，男性 ASR 是全球的 1.7 倍。全球 DALY 的 ASR 峰值出现在 75-79 岁，但在中国更早出现。乙型肝炎病毒是全球（39.5%）和中国（62.5%）的主要病因，其次是丙型肝炎病毒和酒精摄入。在高社会人口指数国家，非酒精性脂肪性肝炎作为病因的比例逐渐增加。全球范围内，各种病因导致的肝癌负担在两性中均有所下降。然而，代谢危险因素，特别是肥胖，对肝癌负担的贡献不断增加，尤其是在男性中。
尽管中国和全球的肝癌负担呈总体下降趋势，但代谢危险因素的贡献不断增加，这突显了实施针对区域和性别差异的有针对性的预防和控制策略的重要性。
