Jiang Zhichao, Zeng Guoqiang, Dai Huajia, Bian Yuhao, Wang Libin, Cao Wei, Yang Junfeng
Department of General Surgery, Shidong Hospital, Shidong Hospital, University of Shanghai for Science and Technology, Yangpu District, 999 Shiguang Road, Shanghai, 200438, China.
Department of Andrology, The First Hospital of Jilin University, Changchun, 130021, Jilin Province, China.
BMC Public Health. 2025 Mar 8;25(1):931. doi: 10.1186/s12889-025-22026-6.
Liver cancer is a growing global health issue, with significant geographical disparities in prevalence and mortality. Understanding these differences is key to developing effective prevention and treatment strategies.
We analyzed liver cancer trends from 1990 to 2021 across 204 countries using data from the Global Burden of Disease (GBD) study. We modeled mortality from vital registration data and estimated non-fatal burden using primary studies, hospital discharges, and claims data. We calculated prevalence, mortality, YLLs, YLDs, and DALYs, adjusting for age and reporting rates per 100,000 population with 95% UI.
In 2021, there were 739,299 (673114-821948) cases of liver cancer worldwide. The age-standardized prevalence rate increased from (7.75 [6.91-8.43] per 100,000 people) in 1990 to (8.68[7.90-9.67] per 100,000 people) in 2021, while the mortality rate slightly decreased from(4.48 [4.10-4.93] per 100,000 people) to (6.13 [5.58-6.84] per 100,000 people). High-income North America had the highest prevalence rate, and Southern Latin America had the lowest. Mongolia had the highest prevalence and mortality rates, while Morocco had the lowest. The total YLDs attributed to liver cancer nearly tripled from 1990 to 2021, and the age-standardized DALY rate decreased. In the frontier analysis, countries or regions with higher SDI have greater potential for burden improvement. In the frontier analysis of SDI and age-standardized liver cancer DALY rates in 2021, countries with higher SDI (> 0.85) and higher effective differences relative to their level of development include America, Canada, Germany, Netherlands, etc., while frontier countries with lower SDI (< 0.5) and lower effective differences include Somalia, Papua New Guinea, Yemen, Lao People's Democratic Republic, etc. Countries with larger effective differences include Togo, Gambia, Australia, Norway, etc. CONCLUSION: The global burden of liver cancer is decreasing, but the prevalence of liver cancer is increasing, with significant differences across regions worldwide. These findings can inform health policy and research to address this global challenge.
From 1990 to 2021, the incidence of liver cancer in many regions has increased significantly, which is expected to impose a huge social and economic burden on governments and health systems in the coming years. Our research findings may assist policymakers in devising strategies to combat liver cancer, including educating professionals to address the burden of this complex disease.
肝癌是一个日益严重的全球健康问题，在患病率和死亡率方面存在显著的地域差异。了解这些差异是制定有效预防和治疗策略的关键。
我们使用全球疾病负担（GBD）研究的数据，分析了1990年至2021年期间204个国家的肝癌趋势。我们根据生命登记数据对死亡率进行建模，并使用原始研究、医院出院数据和理赔数据估计非致命负担。我们计算了患病率、死亡率、伤残调整生命年（YLLs）、伤残调整生命年（YLDs）和伤残调整生命年（DALYs），并根据年龄进行调整，以每10万人为单位报告发病率，并给出95%的不确定区间（UI）。
2021年，全球有739,299例（673114 - 821948例）肝癌病例。年龄标准化患病率从1990年的每10万人7.75例（6.91 - 8.43例）增至2021年的每10万人8.68例（7.90 - 9.67例），而死亡率则从每10万人4.48例（4.10 - 4.93例）略微降至每10万人6.13例（5.58 - 6.84例）。高收入的北美地区患病率最高，而拉丁美洲南部地区最低。蒙古的患病率和死亡率最高，而摩洛哥最低。归因于肝癌的总伤残调整生命年（YLDs）从1990年到2021年几乎增加了两倍，且年龄标准化伤残调整生命年（DALY）率有所下降。在前沿分析中，社会人口指数（SDI）较高的国家或地区在减轻负担方面具有更大潜力。在2021年社会人口指数（SDI）与年龄标准化肝癌伤残调整生命年（DALY）率的前沿分析中，社会人口指数（SDI）较高（> 0.85）且相对于其发展水平有效差异较大的国家包括美国、加拿大、德国、荷兰等，而社会人口指数（SDI）较低（< 0.5）且有效差异较小的前沿国家包括索马里、巴布亚新几内亚、也门、老挝人民民主共和国等。有效差异较大的国家包括多哥、冈比亚、澳大利亚、挪威等。结论：全球肝癌负担正在减轻，但肝癌患病率却在上升，全球各地区存在显著差异。这些研究结果可为应对这一全球挑战的卫生政策和研究提供参考。
1990年至2021年期间，许多地区的肝癌发病率显著上升，预计未来几年将给各国政府和卫生系统带来巨大的社会和经济负担。我们的研究结果可能有助于政策制定者制定抗击肝癌的策略，包括培训专业人员以应对这一复杂疾病的负担。
