Previously submitted to: JMIR Public Health and Surveillance (no longer under consideration since Mar 05, 2024)
Date Submitted: Jul 19, 2023
Open Peer Review Period: Jul 19, 2023 - Aug 2, 2023
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Changing epidermiology of liver cancer burden from 2010 to 2016 in China: NASH is the fast growing cause
ABSTRACT
Background:
With the rising prevalence of obesity, increasing alcohol consumption and the advances in hepatitis B virus (HBV) and C virus (HCV) treatment, liver cancer epidermiology gradually changes. However, the impact of these changes on liver cancer burden in China remains unclear.
Objective:
This study aimed to assess temporal trends in liver cancer burden across the whole country and 33 province-level administrative regions and the contributions of various liver cancer etiologies in China from 2010 to 2016.
Methods:
In this observational trend study, we collected data on incident cases, deaths cases, disability-adjusted life-years (DALYs), and age-standardised incidence/death rate for liver cancer between 2010 and 2016, by sex, age and cause using data from the Global Burden of Disease study 2016. The ASRs of liver cancer-related incidence and mortality in 33 province-level administrative regions of China were obtained from the National Central Cancer Registry (NCCR), which collected registration data from 2016 from a total of 682 cancer registries. The estimated annual percentage changes in the age-standardised incidence/death rate were calculated to quantify the changing trend.
Results:
Between 2010 and 2016, there was a 25% increase in incident liver cancer cases and a 22% increase in liver cancer deaths in China, while the ASIR and ASDR remained stable. South China, especially rural South, had the highest ASIR and ASDR of liver cancer, while North China had the lowest incidence rate and death rate in the whole country in 2016. The proportion of alcohol and non-alcoholic steatohepatitis (NASH)-assoicated liver cancer incidence and death increased, while the proportion of HBV-associated liver cancer incidence and death decreased between 2010 and 2016. NASH was the only etiology with an increase in liver cancer ASIRs, and alcohol also showed the fast growing incidence of liver cancer in some age groups.
Conclusions:
Urgent measures are required at a national level to tackle the underlying metabolic risk factors and slow down the rising burden of NASH-induced liver cancer.
Citation
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