Li Jinbo, Bai Hongjing, Gao Ziyi, Gao Linying, Wang Weigang, Li Yandi, Lian Jia, Yao Tian, Wang Keke, Hao Ruigang, Wang Suping, Feng Yongliang
School of Public Health, Shanxi Medical University, Taiyuan, 030001, China.
Center of Clinical Epidemiology and Evidence Based Medicine, Shanxi Medical University, Taiyuan, 030001, China.
Hepatol Int. 2025 Apr;19(2):368-383. doi: 10.1007/s12072-024-10765-4. Epub 2024 Dec 19.
This study comprehensively assessed the burden of liver cancer due to hepatitis B (LCHB) from 1990 to 2021, analyzing temporal trends in disease burden and associations with age, period and birth cohort.
Age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR) of LCHB from 1990 to 2021 were collected from the Global Burden of Disease (GBD) 2021. Joinpoint regression analysis estimated long-term trends. Age-period-cohort analysis evaluated the independent effects of age, period and cohort. Decomposition analysis elucidated the impact of population growth, aging and epidemiological changes on the burden.
Between 1990 and 2019, the ASIR and ASMR of LCHB witnessed an overall declining trend worldwide, with a notably higher burden in males compared to females. The highest ASIR and ASMR were observed in the middle socio-demographic index (SDI) region, while the lowest were in the low-middle SDI region, with substantial differences across countries. Age-period-cohort analysis revealed an initial increase in risk followed by a decline with advancing age, with the burden primarily affecting the elderly. Decomposition analysis indicated that population growth and aging were the primary drivers of the increase in incident cases and deaths.
From 1990 to 2021, the ASIR and ASMR of LCHB decreased globally. However, population growth and aging contributed to an increase in the absolute numbers of incident cases and deaths. The risk burden increased with age, and favourable period and cohort effects were found in all SDI regions.
本研究全面评估了1990年至2021年期间乙型肝炎所致肝癌（LCHB）的负担，分析了疾病负担的时间趋势以及与年龄、时期和出生队列的关联。
从《2021年全球疾病负担》（GBD 2021）中收集1990年至2021年LCHB的年龄标准化发病率（ASIR）和年龄标准化死亡率（ASMR）。采用Joinpoint回归分析估计长期趋势。年龄-时期-队列分析评估年龄、时期和队列的独立效应。分解分析阐明了人口增长、老龄化和流行病学变化对负担的影响。
1990年至2019年期间，全球LCHB的ASIR和ASMR总体呈下降趋势，男性负担明显高于女性。社会人口学指数（SDI）中等地区的ASIR和ASMR最高，而中低SDI地区最低，各国之间存在显著差异。年龄-时期-队列分析显示，风险最初增加，随后随着年龄增长而下降，负担主要影响老年人。分解分析表明，人口增长和老龄化是发病病例和死亡人数增加的主要驱动因素。
1990年至2021年期间，全球LCHB的ASIR和ASMR有所下降。然而，人口增长和老龄化导致发病病例和死亡的绝对数量增加。风险负担随年龄增加，所有SDI地区均发现了有利的时期和队列效应。
