[Epidemiological characteristics of liver cancer in China and worldwide]

Objective: To describe and analyze the incidence, mortality and epidemiological trends of liver cancer in China and selected regions worldwide, providing data references for liver cancer prevention and control. Methods: Data on the incidence, mortality, historical trends, and projected estimates for 2050 of liver cancer were extracted from the GLOBOCAN 2022 database. Epidemiological characteristics of liver cancer in China and other region were described and compared by region, age, sex and human development index (HDI). Spearman's test was used to examine the relationships between HDI and age-standardized incidence rate (ASIR) or age-standardized mortality rate (ASMR) across regions. The average annual percentage change (AAPC) in ASIR was calculated using Joinpoint regression analysis. Results: In 2022, the number of new cases and deaths of liver cancer in the global were 866 000 and 759 000 respectively, and the ASIR and ASMR were 8.6/10⁵ and 7.4/10⁵, respectively. Both ASIR and ASMR were higher in males than in females. In China, there were 368 000 new cases and 317 000 deaths in 2022, with an ASIR of 15.0/10⁵ and an ASMR of 12.6/10⁵. Globally, the incidence of liver cancer in males peaked in the 65-69 age group, while in Chinese males, two incidence peaks were observed in the 50-54 and 65-69 age groups. Among the elderly (≥65 years), the global ASIR and ASMR were 7.4 and 8.1 times higher, respectively, than those in the working-age population (15-64 years). In China, the ratios of ASIR and ASMR between the elderly and working-age populations were 5.9 and 7.0, respectively. Both ASIR and ASMR were negatively correlated with HDI (ASIR: r=-0.18, P=0.018; ASMR: r=-0.31, P＜0.001). From 2002 to 2017, ASIR of liver cancer showed a declining trend in both males and females in China, Japan, and South Korea (all P＜0.001), with AAPCs of -1.96% for Chinese males and -2.75% for Chinese females. In contrast, the United States experienced an increasing trend in ASIR, with AAPCs of 3.13% for males and 3.12% for females (both P＜0.001). Projections indicate that by 2050, the number of new cases and deaths globally will reach 1.564 million and 1.421 million, representing increases of 80.6% and 87.2% compared to 2022, respectively. In China, the number of new cases and deaths are projected to be 560 000 and 514 000, increases of 52.2% and 62.1% from 2022, respectively. Conclusions: The burden of liver cancer varies significantly across regions, sexes, and age groups worldwide. Incidence and mortality rates are negatively correlated with HDI. The global burden of liver cancer is expected to continue increasing, underscoring the need for enhanced comprehensive prevention and control strategies.