BACKGROUND The incidence of primary liver cancer (PLC) continues to increase worldwide. The incidence trends and patterns of PLC associated with different age at diagnosis remain unknown. METHODS We collected detailed information on PLC between 1990 and 2017 from Global Burden of Disease Study 2017. Estimated annual percentage changes in the PLC age-standardized incidence rate (ASR) diagnosed by age, sex, region, and etiology were calculated to quantify the temporal trends in PLC ASR. RESULTS Globally, the number of PLC cases for which the age at diagnosis was <30 years decreased from 17,381 in 1990 to 14,661 in 2017, whereas the number of PLC cases diagnosed at age 30 to 59 and ≥60 years old increased from 216,561 and 241,189 in 1990 to 359,770 and 578,344 in 2017, respectively. The ASR of PLC cases with age at diagnosis <30 years and between 30 and 59 years decreased in both sexes, whereas the ASR of PLC with age at diagnosis ≥60 years increased in males and remained stable in females at the global level. Males had a more dramatic increase in PLC diagnosed at age ≥60 years but a milder decrease in PLC diagnosed between 30 and 59 years of age. This decrease was attributed largely to the reduction in PLC caused by hepatitis B and hepatitis C and was consistent in most regions except for developed countries, in which the ASR of PLC increased irrespective of sex and age. The ASR of PLC due to nonalcoholic steatohepatitis (NASH) increased by the greatest magnitude in most regions. CONCLUSION PLC in highly endemic regions has been partly alleviated due to the potent control of hepatitis, especially among young and middle-aged people. However, an unfavorable trend was observed in most developed countries and in elderly populations. As such, PLC prevention schedules should give more attention to NASH and elderly patients.

中文翻译：

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1990-2017年按诊断，性别，地区和病因分年龄的原发性肝癌全球发病率趋势。

背景技术世界范围内原发性肝癌（PLC）的发病率持续增加。与不同年龄的诊断相关的PLC的发病趋势和模式仍然未知。方法我们从《 2017年全球疾病负担研究》中收集了1990年至2017年间有关PLC的详细信息。计算了按年龄，性别，地区和病因诊断的PLC年龄标准化发病率（ASR）的估计年度百分比变化，以量化时间PLC ASR的趋势。结果在全球范围内，诊断时年龄小于30岁的PLC病例从1990年的17,381例下降到2017年的14,661例，而30岁至59岁且≥60岁的PLC病例数从216,561和241,189例增加1990年分别为359,770和2017年的578,344。诊断年龄的PLC病例的ASR < 在全球范围内，男性的30岁和30至59岁之间均下降，而诊断为60岁以上的PLC的ASR在男性中增加，在女性中保持稳定。男性在≥60岁时被诊断出的PLC的增加更为显着，但在30至59岁之间被诊断出的PLC的下降则较轻。这一下降主要归因于乙型肝炎和丙型肝炎引起的PLC减少，除发达国家（不论性别和年龄），PLC的ASR有所增加外，在大多数地区都是一致的。在大多数地区，非酒精性脂肪性肝炎（NASH）引起的PLC的ASR增幅最大。结论由于对肝炎的有效控制，特别是在年轻人和中年人中，高流行地区的PLC得到部分缓解。然而，在大多数发达国家和老年人口中观察到不利的趋势。因此，PLC预防计划应更加关注NASH和老年患者。