Global incidence of liver cancer increased by 75 percent in the past 15 years
The Global Burden of Disease (GBD) 2015 study showed that the incidence of liver cancer had increased by 75 percent from 1990 to 2015, with hepatitis B virus (HBV) and hepatitis C virus (HCV) infection and alcoholism accounting for most cases of liver cancer deaths.
In the recently published systematic review that analyzed vital registration and cancer registry data in an ensemble modelling approach, there were 854,000 cases of liver cancer and 810,000 deaths globally in 2015, which contributed to 20,578,000 total years lived with disability (DALY). The review also reported a worldwide increase in liver cancer incidence of 75 percent between 1990 and 2015. [JAMA Oncol 2017, doi: 10.1001/jamaoncol.2017.3055]
The highest burden of liver cancer incident cases was mainly observed in Asia (East Asia, 394 x 103; Southeast Asia, 67 x 103), with the number of cases almost 400 times higher than that in the area with the lowest incidence (Oceania, 1 x 103).
Liver cancer incident cases increased by 75 percent between 1990 and 2015, with changing age structures contributing 47 percent and population growth contributing 35 percent to the overall increase. Owing to demographic changes of ageing and population growth, incident cases increased by 56 and 42 percent, respectively.
Southeast Asia ranked fourth highest in terms of the number of incident cases, but ranked second for liver cancer deaths (71 x 103) and DALYs (1,860 x 103), and fifth for age-standardized mortality rate (ASMR) (14.6 x 103 mean per 100,000 person-years).
Globally, HBV infection (33 percent) accounted for most causes of liver cancer deaths, followed by alcoholism (30 percent), HCV infection (21 percent) and other causes (16 percent).
The researchers predicted that with the present HBV vaccination trends, the number of new HBV infections is estimated to drop by 70 percent in 2050. There is a trend, however, towards increasing incidence rates of liver cancer due to HCV, stressing the importance of prevention via access to highly effective HCV antiviral medication.
“Our analysis also showed an increasing incidence rate between 1990 and 2015 for liver cancer due to alcohol, highlighting the need for strategies to decrease the harmful use of alcohol,” the authors said.
Some countries have already made progress in reducing liver cancer burden over the past decades. China experienced a significant decrease in ASMR of 33 percent between 1990 and 2015, possibly due to reduced exposure to aflatoxins and implementation of national HBV vaccination programmes. [Zhongguo Zhong Liu 2014;23:621-628; Carcinogenesis 2013;34:1800-1805; Eur J Cancer Prev 2003;12:273-279]
“The results of the study show that most causes of liver cancer can be prevented through vaccination, antiviral treatment, safe blood transfusion and injection practices, and interventions to reduce alcohol use,” the authors concluded.
The GBD 2015 study on primary liver cancer incidence, mortality and DALYs involved 195 countries and territories, and presented global, regional and national estimates on the burden of liver cancer due to HBV, HCV, alcohol and other causes.