Yang Si, Deng Yujiao, Zheng Yi, Zhang Jing, He Dongdong, Dai Zhijun, Guo Changcun
Department of Digestive Diseases, Xijing Hospital, Air Force Medical University, Xi'an, 710000, Shaanxi, China.
Department of Digestive Diseases, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Hepatol Int. 2025 Apr;19(2):441-459. doi: 10.1007/s12072-024-10763-6. Epub 2025 Jan 11.
Liver cancer (LC) is a major concern in the Asia-Pacific region, particularly in China, Korea, and Japan. In this study, we aimed to investigate the burden, trends, and predictions related to LC in these countries.
Using data from the Global Burden of Disease Study 2021, the epidemiological characteristics [incidence, deaths, and disability-adjusted life-years (DALYs)] for LC were analysed and stratified by specific etiologies in China, Japan, and South Korea. We examined temporal trends in LC burden over the last 32 years and projected changes over the following 25 years. The risk factors associated with LC deaths and DALYs were also investigated.
In 2021, the highest LC-related incidence, mortality, and DALYs were recorded in China (196,637 incidents, 172,068 mortalities, and 4,890,023 DALYs), and the lowest in South Korea (18,642 incidents, 13,674 deaths, and 326,336 DALYs). South Korea recorded the highest age-standardized rates (ASRs) of incidence, mortality, and DALYs for LC (19.94 per 100,000, 14.53 per 100,000, and 354.57 per 100,000), and Japan the lowest (9.89, 7.29, and 145.74, respectively). From 1990 to 2021, LC incidents and deaths in the three countries increased, and the trends in ASRs decreased. LC incidents and deaths caused by five etiologies also increased in the past 32 years, and non-alcoholic steatohepatitis (NASH) was the largest increasing etiologies in China. Infections with hepatitis B virus remained the leading cause of LC in China and South Korea, while hepatitis C virus was the prevailing cause in Japan. High body mass index (BMI) was the most sharply increasing risk factor in China. Alcohol and drug use were the main risk factors for LC in South Korea and Japan, respectively. The LC burden in the three countries was projected to rise steadily between 2022 and 2046.
LC remains a significant disease burden in China, Japan, and South Korea now and over the next 25 years. Regarding etiologies and risk factors, NASH and high BMI in China, alcohol use in South Korea, and drug use in Japan should receive significant attention.
肝癌是亚太地区的一个主要问题，在中国、韩国和日本尤为突出。在本研究中，我们旨在调查这些国家与肝癌相关的负担、趋势和预测情况。
利用全球疾病负担研究2021年的数据，分析了中国、日本和韩国肝癌的流行病学特征（发病率、死亡率和伤残调整生命年），并按具体病因进行分层。我们研究了过去32年肝癌负担的时间趋势，并预测了未来25年的变化。还调查了与肝癌死亡和伤残调整生命年相关的风险因素。
2021年，中国记录的与肝癌相关的发病率、死亡率和伤残调整生命年最高（196,637例、172,068例死亡和4,890,023伤残调整生命年），韩国最低（18,642例、13,674例死亡和326,336伤残调整生命年）。韩国记录的肝癌发病率、死亡率和伤残调整生命年的年龄标准化率最高（每10万人中分别为19.94例、14.53例和354.57例），日本最低（分别为9.89例、7.29例和145.74例）。从1990年到2021年，这三个国家的肝癌发病数和死亡数增加，年龄标准化率呈下降趋势。在过去32年中，由五种病因导致的肝癌发病数和死亡数也有所增加，非酒精性脂肪性肝炎是中国增加最多的病因。乙肝病毒感染在中国和韩国仍然是肝癌的主要原因，而丙肝病毒在日本是主要病因。高体重指数是中国上升最明显的风险因素。饮酒和药物使用分别是韩国和日本肝癌的主要风险因素。预计在2022年至2046年期间，这三个国家的肝癌负担将稳步上升。
目前以及在未来25年里，肝癌在中国、日本和韩国仍然是一个重大的疾病负担。在病因和风险因素方面，中国的非酒精性脂肪性肝炎和高体重指数、韩国的饮酒以及日本的药物使用应受到高度关注。
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