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Global, regional, and national burden of liver cancer due to non-alcoholic steatohepatitis, 1990–2019: a decomposition and age–period–cohort analysis

  • Original Article―Liver, Pancreas, and Biliary Tract
  • Published:
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Abstract

Background

Identifying past temporal trends in non-alcoholic steatohepatitis (NASH)-associated liver cancer (NALC) can increase public awareness of the disease and facilitate future policy development.

Methods

Annual deaths and age-standardized death rates (ASDR) for NALC from 1990 to 2019 were collected from the Global Burden of Disease (GBD) 2019 study. The long-term trend and the critical inflection of mortality of NALC were detected by Joinpoint analysis. Age–period–cohort analysis was employed to evaluate the effects of age, period, and cohort. Last, decomposition analysis was used to reveal the aging and population growth effects for NALC burden.

Results

Between 1990 and 2019, the ASDR of NALC witnessed an overall declining trend on a global scale, with a decrease in females and a stable trend in males. However, the global ASDR demonstrated a significant upward trend from 2010 to 2019. Southern sub-Saharan Africa and Southeast Asia have the highest NALC burdens, while high socio-demographic index (SDI) region experienced the fastest escalation of NALC burdens over 30 years. The decomposition analysis revealed that population growth and aging were the primary catalysts behind the increase in global NALC deaths. Age–period–cohort analyses showed that NALC mortality declined the fastest among females aged 40–45 years in high SDI region, accompanied by a deteriorating period effect trend during the period of 2010–2019.

Conclusion

The global absolute deaths and ASDR of NALC have witnessed a rise in the past decade, with populations exhibiting considerable disparities based on sex, age, and region. Population growth, aging, and metabolism-related factors were the main factors behind the increase in global NALC deaths.

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Data availability

The data that support the findings of this study are openly available in https://ghdx.healthdata.org.

Abbreviations

AAPC:

Average annual percentage change

APC:

Annual percentage change

ASDR:

Age-standardized death rate

CI:

Confidence interval

GBD:

Global Burden of Disease

NASH:

Non-alcoholic steatohepatitis

NAFLD:

Non-alcoholic fatty liver disease

NALC:

NASH-associated liver cancer

SDI:

Socio-demographic index

T2DM:

Type 2 diabetes mellitus

UI:

Uncertainty interval

WHO:

World Health Organization

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Acknowledgements

We acknowledge GBD2019 collaborators whose outstanding contributions have enabled us to complete this study.

Funding

This study was supported by the project of the Institute of Hospital Management, National Health Care Commission (YLZLXZ22G026) and the self-funded science and technology program of Fuyang City (FK202081016).

Author information

Author notes

  1. Chunlong Liu, Shijie Zhu, Jian Zhang, and Panpan Wu have contributed equally to this paper.

Authors and Affiliations

  1. Department of Hepatobiliary and Pancreatic Surgery, Fuyang People’s Hospital, Anhui Medical University, Fuyang, 236000, China

    Chunlong Liu, Panpan Wu, Xuan Wang, Kun Song & Jiangtao Yu

  2. Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan, 430071, China

    Shijie Zhu

  3. Department of Neurosurgery, the Seventh Clinical College of China Medical University, Fushun, 113001, China

    Jian Zhang

  4. Department of Hepatobiliary and Pancreatic Surgery, Fuyang People’s Hospital, Bengbu Medical College, Fuyang, 236000, China

    Sen Du & Jiangtao Yu

  5. Graduate School, Wannan Medical College, Wuhu, 241000, Anhui, China

    Enzhao Wang & Kun Song

  6. Department of Orthopedics, Fuyang People’s Hospital, Anhui Medical University, Anhui Medical University, Fuyang, 236000, China

    Yunkang Kang

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Contributions

CL, SZ, and JZ: Writing – original draft, Writing – review & editing, Methodology, Formal analysis, Validation, Visualization. XW and PW: Writing – review & editing, Resources, Validation, Data curation. SD and EW: Writing – review & editing, Validation, Data curation. YK: Writing – review & editing, Data curation. KS: Conceptualization, Writing – review & editing, Funding acquisition. JY: Conceptualization, Writing – review & editing, Supervision.

Corresponding authors

Correspondence to Kun Song or Jiangtao Yu.

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Conflict of interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. No support from any organization or activities for the submitted work.

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Ethical approval and consent were not required as this study was based on publicly available data.

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Liu, C., Zhu, S., Zhang, J. et al. Global, regional, and national burden of liver cancer due to non-alcoholic steatohepatitis, 1990–2019: a decomposition and age–period–cohort analysis. J Gastroenterol 58, 1222–1236 (2023). https://doi.org/10.1007/s00535-023-02040-4

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