Junjie Huang1, Veeleah Lok2, Chun Ho Ngai1, Cedric Chu1, Harsh K Patel3, Viveksandeep Thoguluva Chandraseka4, Lin Zhang5,6,7, Ping Chen8, Shanjuan Wang9, Xiang-Qian Lao1,10, Lap Ah Tse1, Wanghong Xu11, Zhi-Jie Zheng12, Martin C S Wong1,7,12. 1. The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China. 2. Department of Global Public Health, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden. 3. Department of Internal Medicine, Ochsner Clinic Foundation, New Orleans, Louisiana, USA. 4. Department of Gastroenterology and Hepatology, Mayo Clinic Arizona, Scottsdale, Arizona, USA. 5. Centre of Cancer Research, Victorian Comprehensive Cancer Centre, Melbourne, Victoria, Australia. 6. Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia. 7. School of Public Health, The Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. 8. Department of Gastroenterology, Ruijing Hospital North, School of Medicine, Shanghai Jiaotong University, Shanghai, China. 9. Department of Gastroenterology, Jiading District Hospital, Shanghai, China. 10. School of Public Health, Zhengzhou University, Zhengzhou, China. 11. School of Public Health, Fudan University, Shanghai, China. 12. Department of Global Health, School of Public Health, Peking University, Beijing, China.
Abstract
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.
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.
Authors: F Donato; A Tagger; U Gelatti; G Parrinello; P Boffetta; A Albertini; A Decarli; P Trevisi; M L Ribero; C Martelli; S Porru; G Nardi Journal: Am J Epidemiol Date: 2002-02-15 Impact factor: 4.897
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Authors: Martin C S Wong; Junjie Huang; Jingxuan Wang; Paul S F Chan; Veeleah Lok; Xiao Chen; Colette Leung; Harry H X Wang; Xiang Qian Lao; Zhi-Jie Zheng Journal: Eur J Epidemiol Date: 2020-05-24 Impact factor: 8.082