- Primary liver cancer (PLC) rates have been increasing globally, and the increase has been driven by older individuals in developed countries, particularly those with nonalcoholic steatohepatitis (NASH).
Why this matters
- Liver cancer was estimated to be the sixth most commonly diagnosed malignancy and fourth leading cause of cancer-related mortality globally in 2018.
- Annual incidence data (1990-2017) were collected from 195 countries and territories.
- Data were also retrieved on 5 etiologies of liver cancer: HBV infection, HCV infection, alcohol use, NASH, and other.
- Funding: National Key Research and Development Program of China; National Natural Science Foundation of China; Science and Technology Commission of Shanghai Municipality; and Shanghai Municipal Science and Technology Major Project.
- An increasing trend was seen in most countries for PLC among individuals age ≥60 years.
- The age-standardized incidence rates of PLC caused by the 5 factors increased significantly in most of the developed regions.
- The magnitude of increase was greatest for NASH-induced liver cancer.
- Vaccination has “dramatically” decreased both the prevalence of HBV infection and the incidence of associated PLC among younger people in high-risk countries.
- However, HCV infection has emerged as a concerning cause of liver cancer among individuals once believed to be at low risk.
- Potential bias from miscoding, underreporting, and underestimation of liver cancer.
- Multietiological liver cancer was not considered.