Kazi Onika, Hamidzadeh Shokoufeh, Ehsani Zunuz Babak, Khordoo Abdolsabour, Mazloomi Seyede Saba, Khademsedaghat Hossein, Khadembashiri Mohammad Amin
School of Medicine, Shahid Beheshti University of Medical University, Tehran, Iran.
Department of Internal Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
Ann Med Surg (Lond). 2025 May 30;87(7):4053-4065. doi: 10.1097/MS9.0000000000003433. eCollection 2025 Jul.
Liver cancer is one of the leading causes of cancer-related deaths worldwide. In Europe, viral hepatitis, alcohol consumption, and metabolic diseases contribute to this burden. Using data from the Global Burden of Disease Study 2021, we report here the liver cancer epidemiology in Europe between 1990 and 2021, describing recent trends, geographical disparities, and the major risk factors influencing disease outcomes.
The Global Burden of Disease Study 2021 provided standardized data on liver cancer incidence, mortality, and disability-adjusted life years (DALYs) across Europe from 1990 to 2021, utilizing advanced statistical modeling tools like DisMod-MR 2.1 to ensure accuracy and comparability. Age-standardized rates (age-standardized incidence rate, ASIR; age-standardized mortality rate (ASMR); and age-standardized DALYs rate, ASDR) were analyzed alongside the socio-demographic Index (SDI) to evaluate trends, regional disparities, and associations using joinpoint regression and LOESS modeling. Data visualization involved Python tools, including choropleth maps and regression plots.
Liver cancer burden in Europe has increased significantly, with the ASIR rising from 3.04 [2.93-3.14] in 1990 to 4.20 [3.93-4.40] in 2021, the ASMR increasing from 3.08 [2.96-3.18] to 3.86 [3.59-4.05], and the ASDR rising from 78.48 [76.09-80.74] to 91.43 [86.48-95.79]. Males consistently showed higher rates than females, and older populations bore the highest burden, with deaths and DALYs peaking in the 95+ age group in 2021. Nationally, Andorra reported the highest ASIR, ASMR, and ASDR in 2021, while Ukraine had the lowest rates. Hepatitis C and alcohol-related liver cancer were the leading contributors, with NASH showing the fastest growth. Regions with higher SDI demonstrated greater burden, highlighting healthcare access and detection disparities.
Liver cancer burden in Europe is driven by rising obesity, aging populations, lifestyle changes, and healthcare disparities, with incidence and mortality growing faster in the Europe, especially the Western region. Comprehensive strategies focusing on prevention, early detection, and equitable access to care are essential.
肝癌是全球癌症相关死亡的主要原因之一。在欧洲，病毒性肝炎、酒精消费和代谢性疾病导致了这一负担。利用全球疾病负担研究2021年的数据，我们在此报告1990年至2021年欧洲的肝癌流行病学情况，描述近期趋势、地理差异以及影响疾病结局的主要风险因素。
全球疾病负担研究2021年提供了1990年至2021年欧洲各地肝癌发病率、死亡率和伤残调整生命年（DALYs）的标准化数据，利用DisMod-MR 2.1等先进统计建模工具确保准确性和可比性。分析年龄标准化率（年龄标准化发病率，ASIR；年龄标准化死亡率，ASMR；以及年龄标准化DALYs率，ASDR）以及社会人口指数（SDI），使用连接点回归和局部加权回归散点平滑法（LOESS）建模来评估趋势、区域差异和关联。数据可视化使用Python工具，包括分级统计图和回归图。
欧洲的肝癌负担显著增加，ASIR从1990年的3.04[2.93 - 3.14]上升至2021年的4.20[3.93 - 4.40]，ASMR从3.08[2.96 - 3.18]增至3.86[3.59 - 4.05]，ASDR从78.48[76.09 - 80.74]升至91.43[86.48 - 95.79]。男性的发病率始终高于女性，老年人群负担最重，2021年95岁及以上年龄组的死亡人数和DALYs达到峰值。在国家层面，安道尔在2021年报告的ASIR、ASMR和ASDR最高，而乌克兰的发病率最低。丙型肝炎和酒精相关肝癌是主要因素，非酒精性脂肪性肝炎（NASH）增长最快。SDI较高的地区负担更重，凸显了医疗服务可及性和检测方面的差异。
欧洲的肝癌负担由肥胖率上升、人口老龄化、生活方式改变和医疗服务差异驱动，欧洲尤其是西部地区的发病率和死亡率增长更快。聚焦预防、早期检测和公平获得医疗服务的综合策略至关重要。
