Global Burden of Hepatoblastoma From 1990 to 2021 and Projection to 2030

Hepatoblastoma (HB) is the most common primary pediatric hepatocellular carcinoma, and the five-year survival rate for HB is the lowest among childhood cancers, as 20% of cases are chemotherapy resistant or unresectable. Understanding the global burden of HB and future trends in HB burden is urgently needed for gastroenterology and hepatology specialists and pediatricians. This study aims to provide a comprehensive assessment of the global burden of hepatoblastoma, predict future trends over the next decade, and offer insights into its management.

Using data from the Global Burden of Disease 2021, trends in HB-related mortality and disability-adjusted life years (DALYs) were analyzed. Age-standardized rates (ASR) and estimated annual percentage changes (EAPC) were employed to measure trends in these outcomes. Joinpoint regression identified trends, while Bayesian age-period-cohort (BAPC) modeling projected the future burden.

Although the global number of HB-related deaths decreased from 1990 to 2021, the number of deaths in 2021 in low socio-demographic index (SDI) regions remained comparable to 1990 levels, with a notable upward trend in 27 countries, particularly in West Africa. Mortality and DALYs rates were highest in the early neonatal period, with the 2-4 years age group also showing the greatest burden. Projections indicate a global decline in HB burden from 2021 to 2030, but regions such as West Africa are likely to face persistent challenges.

In light of rapid population growth and escalating poverty in Africa, early screening and intervention for hepatoblastoma, particularly among children under five in low SDI regions, are critical to reducing the disease burden. These findings have significant implications for liver health policy, emphasizing the need for targeted interventions based on age and region to mitigate the impact of hepatoblastoma.