Age-specific patterns and trends of primary liver cancer: a worldwide incidence analysis

Liver cancer is a prevalent malignancy worldwide and poses a serious health burden. Age is a key parameter in understanding the burden of liver cancer. We aimed to assess the up-to-date incidence patterns and trends for three age-specific liver cancer types: childhood (0-14 years), early-onset (15-49 years), and later-onset (≥50 years) liver cancer.

Incidence data in 2022 were extracted from the GLOBOCAN database and were analyzed by sex, region, Human Development Index (HDI), and country. Annual incidence from 2003 to 2017 for liver cancer and histological subtypes was mainly obtained from the Cancer Incidence in Five Continents Plus database. Estimated annual percentage changes (EAPCs) were used to assess temporal trends. We predicted future new cases based on current incidence rates and global demographic projections to 2050.

In 2022, there were 4642, 108 758, and 752 736 new cases of childhood, early-onset, and later-onset liver cancer, respectively. Age-standardized incidence rates (ASIRs) of childhood and later-onset liver cancer were higher in higher HDI countries, while ASIRs of early-onset liver cancer were higher in lower HDI countries. Significant increasing trends in ASIRs of later-onset liver cancer were observed in most regions. ASIRs of early-onset liver cancer increased significantly in both sexes in Northern Europe, and in females in Northern America, Western Europe, and Australia/New Zealand, with the upward trend primarily driven by intrahepatic cholangiocarcinoma. For childhood liver cancer, ASIRs increased significantly in males in South America. By 2050, demographic changes will generate increases of 1.6, 21.7, and 84.3% in new cases of childhood, early-onset, and later-onset liver cancer, respectively.

Later-onset liver cancer continues to inflict a tremendous global health burden. The incidence of early-onset liver cancer, especially intrahepatic cholangiocarcinoma, is rising in highly developed regions. Targeted preventive and clinical interventions are required for specific populations based on local priorities.