Background: This study aimed to evaluate the updated disease burden, risk factors, and temporal trends of liver cancer based on age, sex, and country. Methods: We estimated the incidence of liver cancer and its attribution to hepatitis B virus (HBV) and hepatitis C virus (HCV) in 2018 based on the Global Cancer Observatory and World Health Organization (WHO) Cancer Causes database. We extracted the prevalence of risk factors from the WHO Global Health Observatory to examine the associations by weighted linear regression. The trend analysis used data from the Cancer Incidence in Five Continents and the WHO mortality database from 48 countries. Temporal patterns of incidence and mortality were calculated using average annual percent change (AAPC) by joinpoint regression analysis. Results: The global incidence of liver cancer was (age-standardized rate [ASR]) 9.3 per 100,000 population in 2018, and there was an evident disparity in the incidence related to HBV (ASR 0.2–41.2) and HCV (ASR 0.4–43.5). A higher HCV/HBV-related incidence ratio was associated with a higher level of alcohol consumption (β 0.49), overweight (β 0.51), obesity (β 0.64), elevated cholesterol (β 0.70), gross domestic product (β 0.20), and Human Development Index (HDI; β 0.45). An increasing trend in incidence was identified in many countries, especially for male individuals, population aged ≥50 years, and countries with a higher HCV/HBV-related liver cancer incidence ratio. Countries with the most drastic increase in male incidence were reported in India (AAPC 7.70), Ireland (AAPC 5.60), Sweden (AAPC 5.72), the UK (AAPC 5.59), and Norway (AAPC 4.87). Conclusion: We observed an overall increasing trend of liver cancer, especially among male subjects, older individuals, and countries with a higher prevalence of HCV-related liver cancer. More efforts are needed in enhancing lifestyle modifications and accessibility of antiviral treatment for these populations. Future studies should investigate the reasons behind these epidemiological changes.
Liver Cancer

中文翻译：

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肝癌的疾病负担、风险因素和近期趋势：全球国家层面的分析

背景：本研究旨在根据年龄、性别和国家/地区评估肝癌的最新疾病负担、危险因素和时间趋势。方法：我们根据全球癌症观察站和世界卫生组织（WHO）癌症原因数据库估计了2018年肝癌的发病率及其对乙型肝炎病毒（HBV）和丙型肝炎病毒（HCV）的归因。我们从世卫组织全球卫生观察站提取了危险因素的流行率，以通过加权线性回归检查相关性。趋势分析使用了五大洲癌症发病率的数据以及来自 48 个国家的 WHO 死亡率数据库。通过联合点回归分析，使用平均年变化百分比 (AAPC) 计算发病率和死亡率的时间模式。结果：2018 年全球肝癌发病率（年龄标准化率 [ASR]）为每 10 万人 9.3 人，与 HBV（ASR 0.2-41.2）和 HCV（ASR 0.4-43.5）相关的发病率存在明显差异。较高的 HCV/HBV 相关发病率与较高的饮酒水平（β 0.49）、超重（β 0.51）、肥胖（β 0.64）、胆固醇升高（β 0.70）、国内生产总值（β 0.20）、和人类发展指数（HDI；β 0.45）。许多国家的发病率呈上升趋势，特别是男性个体、≥50 岁的人群以及 HCV/HBV 相关肝癌发病率较高的国家。印度（AAPC 7.70）、爱尔兰（AAPC 5.60）、瑞典（AAPC 5.72）、英国（AAPC 5.59）和挪威（AAPC 4.87）报告了男性发病率增幅最大的国家。结论：我们观察到肝癌总体呈上升趋势，尤其是在男性受试者、老年人和 HCV 相关肝癌患病率较高的国家中。需要更多努力来改善这些人群的生活方式改变和抗病毒治疗的可及性。未来的研究应该调查这些流行病学变化背后的原因。
肝癌