The trends in incidence of primary liver cancer caused by specific etiologies: Results from the Global Burden of Disease Study 2016 and implications for liver cancer prevention
The trends in incidence of primary liver cancer caused by specific etiologies: Results from the Global Burden of Disease Study 2016 and implications for liver cancer prevention
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DOI：
10.1016/j.jhep.2018.12.001
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发表时间：
2019-04-01
影响因子：
25.7
通讯作者：
Chen, Xingdong
中科院分区：
文献类型：
--
作者：
Liu, Zhenqiu;Jiang, Yanfeng;Chen, Xingdong
背景与目的：肝癌是世界范围内常见的恶性肿瘤。肝癌的病因多种多样，而特定病因引起的肝癌的发病趋势却鲜有研究。因此，我们的目的是确定肝癌发病的模式以及时间趋势。方法：我们收集了 1990 年至 2016 年间肝癌病因的详细信息，这些信息源自 2016 年的全球疾病负担研究。计算按性别、地区和病因划分的肝癌年龄标准化发病率 (ASR) 的估计年度百分比变化 (EAPC)，以量化肝癌 ASR 的时间趋势。结果：全球范围内，肝癌的发病病例癌症患者从 1990 年的 471,000 例增加到 2016 年的 1,007,800 例，增加了 114.0%。在此期间，总体 ASR 平均每年增加 0.34% (95% CI 0.22%-0.45%)。 1990年至2016年间，乙型肝炎、丙型肝炎和其他原因引起的肝癌ASR增加。相应的EAPC分别为0.22（95% CI 0.08-0.36）、0.57（95% CI 0.48-0.66）和0.51（95% CI 0.41-0.62）。据报道，饮酒导致肝癌的 ASR 保持稳定（EAPC = 0.10，95% CI -0.06-0.25）。这种增长模式在不同地区和国家之间存在差异。最明显的增长通常发生在社会人口指数较高的国家，包括荷兰、英国和美国。结论：尽管乙型肝炎和丙型肝炎病毒感染的控制导致某些地区发病率下降，但肝癌仍然是全球主要的公共卫生问题。我们观察到社会人口指数高的国家出现了不利的趋势，这表明当前的预防策略应该重新调整，一些国家应该制定更有针对性和具体的策略来阻止肝癌的增加。 总结：肝癌是世界范围内常见的恶性肿瘤。世界各地由不同病因引起的肝癌的发病模式差异很大。在这项研究中，我们的目的是确定肝癌的发病模式以及时间趋势，从而有助于制定更有针对性的肝癌预防策略。 (C) 2018 年欧洲肝脏研究协会。由 Elsevier B.V. 出版。保留所有权利。
Background & Aims: Liver cancer is a common malignant neoplasm worldwide. The etiologies for liver cancer are diverse and the incidence trends of liver cancer caused by specific etiologies are rarely studied. We therefore aimed to determine the pattern of liver cancer incidence, as well as temporal trends.Methods: We collected detailed information on liver cancer etiology between 1990-2016, derived from the Global Burden of Disease study in 2016. Estimated annual percentage changes (EAPCs) in liver cancer age standardized incidence rate (ASR), by sex, region, and etiology, were calculated to quantify the temporal trends in liver cancer ASR.Results: Globally, incident cases of liver cancer increased 114.0% from 471,000 in 1990 to 1,007,800 in 2016. The overall ASR increased by an average 0.34% (95% CI 0.22%-0.45%) per year in this period. The ASR of liver cancer due to hepatitis B, hepatitis C, and other causes increased between 1990 and 2016. The corresponding EAPCs were 0.22 (95% CI 0.08-0.36), 0.57 (95% CI 0.48-0.66), and 0.51 (95% CI 0.41-0.62), respectively. The ASR of liver cancer due to reported alcohol use remained stable (EAPC = 0.10, 95% CI -0.06-0.25). This increasing pattern was heterogeneous across regions and countries. The most pronounced increases were generally observed in countries with a high socio-demographic index, including the Netherlands, the UK, and the USA.Conclusions: Liver cancer remains a major public health concern globally, though control of hepatitis B and C virus infections has contributed to the decreasing incidence in some regions. We observed an unfavorable trend in countries with a high socio-demographic index, suggesting that current prevention strategies should be reoriented, and much more targeted and specific strategies should be established in some countries to forestall the increase in liver cancer.Lay summary: Liver cancer is a common malignant neoplasm worldwide. The incidence patterns of liver cancer caused by different etiologies varied considerably across the world. In this study, we aim to determine the pattern of liver cancer incidence as well as the temporal trends, thereby facilitating the establishment of more tailored prevention strategies for liver cancer. (C) 2018 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.