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. 2022 Jul 5;34(7):969-977.e2.
doi: 10.1016/j.cmet.2022.05.003. Epub 2022 Jun 3.

Changing global epidemiology of liver cancer from 2010 to 2019: NASH is the fastest growing cause of liver cancer

Daniel Q Huang  1 , Amit G Singal  2 , Yuko Kono  3 , Darren J H Tan  4 , Hashem B El-Serag  5 , Rohit Loomba  6
Affiliations

Changing global epidemiology of liver cancer from 2010 to 2019: NASH is the fastest growing cause of liver cancer

Daniel Q Huang et al. Cell Metab. .

Abstract

Liver cancer epidemiology is changing due to increasing alcohol consumption, rising prevalence of obesity, and advances in hepatitis B virus (HBV) and hepatitis C virus (HCV) treatment. However, the impact of these changes on global liver cancer burden remains unclear. We estimated global and regional temporal trends in the burden of liver cancer and the contributions of various liver disease etiologies using the methodology framework of the Global Burden of Disease study. Between 2010 and 2019, there was a 25% increase in liver cancer deaths. Age-standardized death rates (ASDRs) increased only in the Americas and remained stable or fell in all other regions. Between 2010 and 2019, non-alcoholic steatohepatitis (NASH) and alcohol had the fastest growing ASDRs, while HCV and HBV declined. Urgent measures are required at a global level to tackle underlying metabolic risk factors and slow the growing burden of NASH-associated liver cancer, especially in the Americas.

Keywords: alcohol; epidemiology; etiology; hepatitis B; hepatitis C; hepatocellular carcinoma; hepatoma; liver cancer; nonalcoholic steatohepatitis.

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Conflict of interest statement

Declaration of interests R.L. serves as a consultant to Aardvark Therapeutics, Altimmune, Anylam/Regeneron, Amgen, Arrowhead Pharmaceuticals, AstraZeneca, Bristol-Myer Squibb, CohBar, Eli Lilly, Galmed, Gilead, Glympse Bio, Hightide, Inipharma, Intercept, Inventiva, Ionis, Janssen Inc., Madrigal, Metacrine, Inc., NGM Biopharmaceuticals, Novartis, Novo Nordisk, Merck, Pfizer, Sagimet, Theratechnologies, 89 Bio, Terns Pharmaceuticals, and Viking Therapeutics and is cofounder of LipoNexus Inc. D.Q.H. has served as an advisory board member for Eisai. A.G.S. has served as a consultant or on advisory boards for Genentech, AstraZeneca, Bayer, Eisai, Exelixis, Wako Diagnostics, Exact Sciences, Roche, Glycotest, and GRAIL.

Figures

Figure 1.
Figure 1.. Estimated global death cases and age-standardized death rates of liver cancer from 2010 to 2019
(A) Frequency of liver cancer deaths in 2010 versus 2019, global and by World Health Organization region. (B) Frequency of liver cancer deaths by World Health Organization region from 2010 to 2019. (C) Contribution to global liver cancer deaths in 2019 by World Health Organization region. (D) Age-standardized death rates of liver cancer by World Health Organization region in 2010 versus 2019. (E) Age-standardized death rates of liver cancer by World Health Organization region from 2010 to 2019. (F) Frequency of liver cancer deaths in 2010 versus 2019 by sociodemographic index. (G) Age-standardized death rates of liver cancer from 2010 to 2019 by sociodemographic index ASDR, age-standardized death rate; SDI, sociodemographic index.
Figure 2.
Figure 2.. Estimated age-standardized death rates from liver cancer in 2019 by country
Figure 3.
Figure 3.. Temporal trends in the etiology of liver cancer from 2010 to 2019
(A) Frequency of liver cancer deaths in 2010 versus 2019 by etiology. (B) Contribution to frequency of liver cancer deaths by etiology in 2019. (C) Frequency of deaths from liver cancer by region and etiology from 2010 to 2019. (D) Estimated age-standardized death rates of liver cancer in 2010 versus 2019 by World Health Organization region and etiology. (E) Estimated age-standardized death rates of liver cancer in 2010 versus 2019 by sociodemographic index and etiology. NASH; nonalcoholic steatohepatitis; ASDR, age-standardized death rate; SDI, sociodemographic index.
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