Chen Cong, Zhou Ying, Gu Weiwei, Gu Zhuxin, Jia Pengfei, Si Luyi, Zhao Suming, Zhao Hui
Department of Interventional and Vascular Surgery, Affiliated Hospital of Nantong University, Nantong, China.
Medical School, Nantong University, Nantong, China.
Discov Oncol. 2025 Jul 21;16(1):1384. doi: 10.1007/s12672-025-03174-y.
Liver cancer (LC) is a major global health burden, with hepatocellular carcinoma (HCC) accounting for 75-85% of cases. Drug use, including legal and illicit substances, has emerged as a significant yet underrecognized risk factor for LC, contributing to viral hepatitis transmission, direct hepatotoxicity, and metabolic disorders. This study aims to assess the global and regional trends in drug-induced LC mortality and disease burden from 1990 to 2021 and project future trends up to 2040 using data from the Global Burden of Disease (GBD) 2021 database.
Utilizing GBD 2021 data, we analyzed age-standardized death rates (ASDR), disability-adjusted life years (DALYs), and estimated annual percentage changes (EAPC) to evaluate trends in drug-induced LC mortality globally and across Socio-Demographic Index (SDI) regions. The Bayesian Age-Period-Cohort (BAPC) model was employed to project future disease burden. Subgroup analyses were conducted using sex, age, and SDI categories to identify distinct patterns of change.
From 1990 to 2021, global deaths from drug-induced LC increased nearly fourfold, with ASDR rising from 0.32 to 0.83 per 100,000 (EAPC = 1.81). DALYs increased significantly, from 9.60 to 20.42 per 100,000 (EAPC = 1.22). Women exhibited higher EAPC values for ASDR (2.36) and DALYs (1.87) compared to men, indicating that the relative rate of increase in the disease burden over time is greater for women. High SDI regions experienced the largest increases in ASDR and DALYs, while low SDI regions showed slower but steady growth. Projections suggest a plateau in ASDR and DALYs before 2030, followed by a decline by 2040.
The global burden of drug-induced LC has increased significantly, with notable disparities across regions and genders. High SDI regions face the fastest-growing burden, while low SDI regions experience rising mortality and morbidity. These findings underscore the need for targeted public health interventions to address drug use and LC prevention, particularly in high-risk populations and regions.
肝癌是一项重大的全球健康负担，其中肝细胞癌（HCC）占病例的75 - 85%。药物使用，包括合法和非法药物，已成为肝癌一个重要但未得到充分认识的风险因素，它会导致病毒性肝炎传播、直接肝毒性和代谢紊乱。本研究旨在利用全球疾病负担（GBD）2021数据库的数据，评估1990年至2021年药物性肝癌死亡率和疾病负担的全球及区域趋势，并预测到2040年的未来趋势。
利用GBD 2021数据，我们分析了年龄标准化死亡率（ASDR）、伤残调整生命年（DALY）和估计年百分比变化（EAPC），以评估全球及社会人口指数（SDI）各区域药物性肝癌死亡率的趋势。采用贝叶斯年龄 - 时期 - 队列（BAPC）模型预测未来疾病负担。使用性别、年龄和SDI类别进行亚组分析，以确定不同的变化模式。
从1990年到2021年，药物性肝癌导致的全球死亡人数增加了近四倍，ASDR从每10万人0.32上升至0.83（EAPC = 1.81）。DALY显著增加，从每10万人9.60增至20.42（EAPC = 1.22）。与男性相比，女性的ASDR（2.36）和DALY（1.87）的EAPC值更高，这表明随着时间推移，女性疾病负担的相对增长率更高。高SDI区域的ASDR和DALY增长幅度最大，而低SDI区域增长较慢但较为稳定。预测表明，ASDR和DALY在2030年前将趋于平稳，随后到2040年将下降。
药物性肝癌的全球负担显著增加，在区域和性别方面存在显著差异。高SDI区域面临的负担增长最快，而低SDI区域的死亡率和发病率不断上升。这些发现强调需要采取有针对性的公共卫生干预措施来解决药物使用和肝癌预防问题，特别是在高危人群和地区。
