Burden, Trends and Projections of Liver Cancer in China and G20 countries: a comparative study based on the Global Burden of Disease database 2021

Yi-fan He¹Ya-meng Liu²Bingnan Ren¹Jing An¹Yu -Pei Wu¹Jian-Qun Zhao¹Yin-Ling Ma^1*Wei He^2*Huizhen Wu^1*

• ¹Hebei General Hospital, Shijiazhuang, China
• ²The Second Hospital of Hebei Medical University, Shijiazhuang, China

Purpose:This study aims to comprehensively compare and analyze the burden of liver cancer in China and the Group of 20 (G20) countries from 1990 to 2021, based on the latest Global Burden of Disease (GBD) 2021 database. It also predicts the trends in liver cancer incidence, prevalence, mortality, and disability-adjusted life years (DALYs) in China and G20 countries over the next 15 years. Methods:This observational longitudinal study utilizes data from the GBD 2021 database, employing indicators that include incidence, mortality, prevalence, DALYs, and age-standardized rates (ASRs). to assess liver cancer trends. The Joinpoint regression model was used to calculate the annual average percentage change to determine long-term trends of significant changes in liver cancer occurrence in China and G20 countries. The ARIMA model was employed to predict the burden trends of liver cancer in China and G20 countries from 2022 to 2036. Results: In 2021, the age-standardized incidence rate (ASIR), the age-standardized prevalence rate (ASPR), age-standardized mortality rate (ASMR), and age-standardized DALYs rate (ASDR) for liver cancer in China have a decrease compared to 1990. The ASIR, ASPR, ASMR, and ASDR for G20 countries in 1990 and 2021 were substantially lower than those of China during the same periods. Joinpoint regression analysis demonstrated an overall decline in the ASMR and ASDR of liver cancer in China and G20 countries from 1990 to 2021. Liver cancer incidents and deaths caused by five etiologies also increased from 1990 to 2021, and non-alcoholic steatohepatitis was the largest increasing etiologies in China. Infections with hepatitis B virus remained the leading etiology of liver cancer in China and G20 countries. Projections indicate that between 2022 and 2036, both China and G20 countries will experience predominantly modest changes in ASRs. Conclusion: Due to the implementation of preventive strategies, advancements in healthcare, and improved economic conditions, the incidence, prevalence, mortality, and DALYs of liver cancer in China have decreased. However, there remains a certain gap compared to G20 countries at the same time. In the future, China should develop more detailed prevention and control strategies targeting risk factors, tailored to men, women, and different age groups.