Work

Trends and health inequalities of hepatitis virus-associated liver cancer mortality during 1990–2050

Year: 2025

Type: article

Abstract: INTRODUCTION AND OBJECTIVES: Liver cancer (LC) is a leading cause of cancer-related deaths worldwide. Hepatitis B/C virus -associated LC (HBC/HCC) remains the primary cause of liver cancer, and it imposes a heavy burden on public health. This study aimed to estimate the mortality and health inequalities of hepatitis B/C virus (HBV/HCV)-associated LC at the global, regional and national levels to provide guidance to reduce the mortality burden of LC. MATERIALS AND METHODS: We extracted the HBV/HCV-associated LC mortality data from the GBD 2021 study during 1990-2021 and analyzed its temporal and spatial trends and forecasted to 2050. Average annual percent change (AAPC) was calculated by joinpoint regression to evaluate the variation of ASMRs, and factors impacting mortality were evaluated through decomposition analysis. The Bayesian spatiotemporal model was used to fit the relationship between age-standardized mortality rate (ASMR) of 204 countries/territories and spatial effects, temporal effects, and spatio-temporal interaction effects. Frontier analysis was conducted to evaluate the minimum achievable ASMR in each country or territory by 2050 and its potential space for ASMR improvement in 2050. RESULTS: Globally, LC deaths doubled from 238,969 in 1990 to 483,875 in 2021. Compared with 1990, the proportions of HBV and HCV in the mortality rate of LC in 2021 were 37.45 % and 30.28 %, corresponding to a decrease of 7.13 % and an increase of 3.44 %, respectively. From 1990 to 2021, the global ASMR of LC (AAPC:0.11, 95 % CI:0.35 to 0.12) and LCC (AAPC: 0.05, 95 % CI:0.26 to 0.36) remained stable, while LCB decreased (AAPC:0.54, 95 % CI:0.81 to -0.27). ASMRs for LC and LCB was the highest in the Western Pacific Region (WPR), but significant declines were observed. The highest ASMR of LCB and LCC shifted from WPR to the Eastern Mediterranean Region (EMR). It is expected that the global ASMR of LC will decrease by 2050. From 1990 to 2021, population growth and age structure were the primary drivers for the increase of LC mortality globally and in Southeast Asia, and age structure is projected to remain a key factor until 2050. CONCLUSIONS: Hepatitis virus-related LC remains a serious health issue worldwide, with regional variations. Asia contributes the most LC-related deaths. The WPR had the highest ASMR for LC and LCB. ASMR for LC showed the fastest decrease in WPR. For women, Africa had the highest ASMR for LC and LCB, while the Americas had the lowest ASMR for LC. The highest ASMR for LCC shifted from the WPR to the EMR during 1990-2021.

Source: Annals of Hepatology

DOI: 10.1016/j.aohep.2025.102144