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. 2024 Sep 3:14:1381173.
doi: 10.3389/fonc.2024.1381173. eCollection 2024.

The burden of liver cancer in Mongolia from 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019

Oyundari Batsaikhan #  1 , Odgerel Chimed-Ochir #  1 , Tatsuhiko Kubo  1 , Chinburen Jigjidsuren  2 , Vanya Delgermaa  3 , Anuzaya Purevdagva  4 , Amarzaya Sarankhuu  5 , Erdenekhuu Nansalmaa  6 , Uranchimeg Tsegmed  6 , Badral Davgasuren  7 , Oyuntsetseg Purev  8 , Ali H Mokdad  9   10 , Nicole Davis Weaver  9 , Ryenchindorj Erkhembayar  11 , Christopher J L Murray  9   10 , Mohsen Naghavi  9   10
Affiliations

The burden of liver cancer in Mongolia from 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019

Oyundari Batsaikhan et al. Front Oncol. .

Abstract

Background: Liver cancer remains the leading cause of death and public health threat among the Mongolian population. So far, there has been no in-depth analysis to describe the burden of common attributable factors to liver cancer in Mongolia. Therefore, we aimed to explore the most prevalent causes of liver cancer and its trends from 1990 to 2019.

Methods: We extracted the primary liver cancer data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to examine the mortality and morbidity of liver cancer by its etiological types, which included alcohol, viral hepatitis B and C, and non-alcoholic steatohepatitis (NASH). The data was extracted by sex and 5-year age intervals from 1990 to 2019. Data included mortality, incidence, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) of liver cancer among the Mongolian population.

Results: Mongolia had the world's highest age-standardized DALYs for liver cancer (2558.1) in 2019. Alcohol-attributable DALYs (786.6) were 29 times higher than the global average (26.1), and liver cancer due to hepatitis C (752.6) and B (763.2) were 21.5 (35.0) and 10.9 (69.1) times higher, respectively. Over the past 30 years, there has been a steady increase in the incidence and number of deaths caused by liver cancer in Mongolia. In 2019, liver cancer incidence due to alcohol consumption was 3.1 times higher for males than females, and hepatitis B was 2.7 times higher for males than females. However, the incidence of hepatitis C and NASH were slightly higher for females. Deaths from liver cancer accounted for 9.51% (2365) of total deaths in Mongolia in 2019, with a continuously increasing trend in the fraction of death compared to 1990, which was 11 times higher than the global average (0.86%), particularly in females with a 319.6% (95% UI 234.9-435.7) increase observed during the study period. Liver cancer due to hepatitis B, C, and alcohol each shared about one-third of liver cancer deaths.

Conclusion: A comprehensive analysis of the burden of liver cancer in Mongolia reveals alcohol use as a primary cause of liver cancer mortality, particularly affecting men and significantly impacting the disease burden. Viral hepatitis continues to pose a major public health concern in the country. Although significant milestones have progressed, addressing the unique demographic and geographical challenges requires tailored approaches for specific target populations. The evidence generated from this analysis is crucial to support policy guidance, contribute to evidence-based decisions, guide public health prevention measures, and amplify population health promotion and disease prevention throughout Mongolia.

Keywords: GBD; alcohol; hepatitis B; hepatitis C; liver cancer (LC); viral hepatitis.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
(A) Number of incidences and age-standardized incidence rate of liver cancer by sex, 1990–2019. (B) Age-standardized incidence rate of liver cancer by its etiologies, 1990–2019. LC: liver cancer; NASH: nonalcoholic steatohepatitis.
Figure 2
Figure 2
Comparison of age distribution of liver cancer death in males and females in 2019.
Figure 3
Figure 3
DALYs due to liver cancer from 1990 to 2019 in Mongolia. ASR: age-standardized rate; DALYs: disability-adjusted life years; YLLs: years of life lost.
See this image and copyright information in PMC

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