Wang Bo, Xiong Yongqiang, Huang Na, Li Jun, Zhang Shu
Department of Geriatric General Surgery, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
National & Local Joint Engineering Research Center of Biodiagnostics and Biotherapy, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Int J Surg. 2025 Jun 20. doi: 10.1097/JS9.0000000000002752.
Primary liver cancer (PLC) is a major cause of cancer mortality worldwide, particularly among middle-aged and elderly populations. Given increasing life expectancy, understanding PLC burden in these groups is essential.
We obtained data about incidence, deaths, and disability-adjusted-life-years (DALYs) from 2000 to 2021 for PLC aged 55 + from Global Burden of Disease (GBD) 2021. Trends across sociodemographic index (SDI), etiology, age, and sex level were evaluated using age-standardized rates, estimated annual percentage change (EAPC), and percentage change. Bayesian-age-period-cohort (BAPC) model was applied to predict the global burden to 2050.
Globally, the cases of PLC burden among middle-aged and elderly populations increased by 74% in incidence, 67% in deaths, and 59% in DALYs. Despite rising case counts, EAPC for incidence, deaths, and DALYs declined with -0.13, - 0.32, and -0.55. Trends varied by region and SDI level, with reductions in HBV- and HCV-related PLC but increases in non-alcoholic steatohepatitis (NASH) and alcohol use related PLC, particularly in high-SDI regions. Burden was highest and increasing among those aged 75 +, especially for NASH-related PLC. Globally, the male-to-female burden ratio was 2.19, though gender differences varied regionally. Finally, projection indicated that the incidence case will persistently rise from 2021-2050, while incidence rate will decrease first and then increase.
Our study analyzed the global epidemiology of PLC among middle-aged and elderly populations from etiology, age and gender, and conducted a prediction outlook for the next 30 years. These findings contribute to the development of efficient and targeted health strategies to mitigate PLC burden.
原发性肝癌（PLC）是全球癌症死亡的主要原因，在中老年人群中尤为突出。鉴于预期寿命的增加，了解这些人群中的PLC负担至关重要。
我们从《2021年全球疾病负担》（GBD 2021）中获取了2000年至2021年55岁及以上PLC的发病率、死亡人数和伤残调整生命年（DALYs）数据。使用年龄标准化率、估计年百分比变化（EAPC）和百分比变化评估社会人口指数（SDI）、病因、年龄和性别水平的趋势。应用贝叶斯年龄-时期-队列（BAPC）模型预测到2050年的全球负担。
在全球范围内，中老年人群中PLC负担的病例数在发病率方面增加了74%，死亡人数增加了67%，DALYs增加了59%。尽管病例数不断上升，但发病率、死亡人数和DALYs的EAPC分别下降了-0.13、-0.32和-0.55。趋势因地区和SDI水平而异，与乙肝病毒（HBV）和丙肝病毒（HCV）相关的PLC有所减少，但非酒精性脂肪性肝炎（NASH）和酒精使用相关的PLC有所增加，特别是在高SDI地区。75岁及以上人群的负担最高且呈上升趋势，尤其是与NASH相关的PLC。在全球范围内，男性与女性的负担比为2.19，尽管性别差异因地区而异。最后，预测表明，从2021年到2050年，发病病例将持续上升，而发病率将先下降后上升。
我们的研究从病因、年龄和性别方面分析了中老年人群中PLC的全球流行病学，并对未来30年进行了预测展望。这些发现有助于制定高效且有针对性的健康策略，以减轻PLC负担。
