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. 2024 Sep 4;24(1):1098.
doi: 10.1186/s12885-024-12869-4.

Examining the evolving landscape of liver cancer burden in the United States from 1990 to 2019

Omar Al Ta'ani  1 , Yazan Al-Ajlouni  2 , Balaji Jagdish  3 , Himsikhar Khataniar  3 , Wesam Aleyadeh  4   5 , Farah Al-Bitar  6 , Tavankit Singh  3
Affiliations

Examining the evolving landscape of liver cancer burden in the United States from 1990 to 2019

Omar Al Ta'ani et al. BMC Cancer. .

Abstract

Introduction: Liver cancer (LC) is frequently preceded by cirrhosis and poses a significant public health challenge in the United States (US). Recent decades have seen notable shifts in the epidemiological patterns of LC, yet national data guiding the optimal allocation of resources and preventive efforts remain limited. This study aims to investigate the current trends, risk factors, and outcomes of LC in the US.

Methods: This study utilized the Global Burden of Disease (GBD) dataset to collect data on the annual incident cases, deaths, Disability-Adjusted Life Years (DALYs), age-standardized incidence rates (ASIR), age-standardized death rates, and age-standardized DALY rates of primary LC and its etiologies and risk factors, between 1990 and 2019. Percentage changes in incident cases, DALYs, and deaths and the estimated annual percentage change (EAPC) in ASIR and deaths rates of LC were calculated to conduct temporal analysis. Linear regression was applied for the calculation of EAPCs. Correlations of EAPC with socio-demographic index (SDI) were separately evaluated by Pearson correlation analyses.

Results: We observed a marked increase in the ASIR of LC, increasing from 2.22 (95% CI: 2.15-2.27) per 100,000 people in 1990 to 5.23 (95% CI: 4.28-6.29) per 100,000 people in 2019, a percentage change of 135.4%. LC due to hepatitis C followed by alcohol use were the primary factors driving this increase. The ASIR and age-standardized death rates of LC showed a significant average annual increase of 3.0% (95% CI: 2.7-3.2) and 2.6% (95% CI: 2.5-2.8), respectively. There was a significant negative correlation between the SDI and the EAPC in ASIR (ρ = -0.40, p = 0.004) and age-standardized death rates (ρ = -0.46, p < 0.001). In 2019, drug and alcohol use, followed by elevated body mass index (BMI) were the primary risk factors for age-standardized DALY rates attributable to LC.

Conclusion: The increased burden of LC in the US highlights the need for interventions. This is particularly important given that LC is mostly influenced by modifiable risk factors, such as drug and alcohol use, and elevated BMI. Our findings highlight the urgent need for public health interventions targeting socio-economic, lifestyle, and modifiable risk factors to mitigate the escalating burden of LC.

Keywords: Alcohol use; Burden of disease; DALYs; Hepatitis B; Hepatitis C; Hepatocellular carcinoma; Risk factors; United States.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Age-standardized Liver Cancer Incidence Rates by Cause from 1990 to 2019
Fig. 2
Fig. 2
Age-standardized DALY Rates in 1990 and 2019 by State
Fig. 3
Fig. 3
Age standardized DALYs Rate Attributable to Risk Factors
Fig. 4
Fig. 4
Relationship Between the EAPC in ASIR and the Sociodemographic Index
Fig. 5
Fig. 5
Relationship Between the EAPC in Age-Standardized Death Rates and the Sociodemographic Index
See this image and copyright information in PMC

References

    1. Yang JD, Hainaut P, Gores GJ, Amadou A, Plymoth A, Roberts LR. A global view of hepatocellular carcinoma: trends, risk, prevention and management. Nat Rev Gastroenterol Hepatol. 2019;16(10):589–604. 10.1038/s41575-019-0186-y - DOI - PMC - PubMed
    1. Devarbhavi H, Asrani SK, Arab JP, Nartey YA, Pose E, Kamath PS. Global burden of liver disease: 2023 update. J Hepatol. 2023;79(2):516–37. 10.1016/j.jhep.2023.03.017 - DOI - PubMed
    1. El-Serag HB. Epidemiology of viral hepatitis and hepatocellular carcinoma. Gastroenterology. 2012;142(6):1264–e1. 10.1053/j.gastro.2011.12.061 - DOI - PMC - PubMed
    1. Guan X, Xing F, Li Y. Alcohol consumption increases the incidence of hepatocellular carcinoma in patients with hepatitis B cirrhosis but not in patients with hepatitis C cirrhosis. Eur J Gastroenterol Hepatol. 2021;33(9):1218–21. 10.1097/MEG.0000000000001837 - DOI - PubMed
    1. Ertle J, Dechêne A, Sowa JP, Penndorf V, Herzer K, Kaiser G, et al. Non-alcoholic fatty liver disease progresses to hepatocellular carcinoma in the absence of apparent cirrhosis. Int J Cancer. 2011;128(10):2436–43. 10.1002/ijc.25797 - DOI - PubMed

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