Global Trend of Aetioloy-Based Primary Liver Cancer Incidence from 1990 to 2030: A Modelling Study

Background: Temporal trends of primary liver cancer (PLC) vary worldwide. Predictions of PLC incidence and case numbers are critical for the understanding of and planning for the PLC disease burden. Methods: Data on the PLC incidence and case number from 1990 to 2017 were retrieved from Global Burden of Disease database. The estimated average percentage change (EAPC) was calculated to quantify the trends of PLC age standardized incidence rates (ASRs). Bayesian age-period-cohort models were constructed to project the PLC incidence and case numbers through 2030. Findings: Globally, the PLC case number doubled from 472,300 in 1990 to 953,100 in 2017. The case number will further increase to 1,571,200 in 2030, and the ASR will increase from 11.80 per 100,000 in 2018 to 14.08 per 100,000 in 2030. The most pronounced increases were observed in people afflicted by non-alcoholic steatohepatitis (NASH) and in older people. The trends of PLC incidence between 1990 and 2030 were heterogeneous from country to country. For example, China and Brazil is predicted to experience an unfavourable increase after 2017, whereas the increase is expected to cease in the USA and Egypt between 2018 and 2030. The PLC incidence was estimated to consistently decrease in Japan, while increase in Germany, including young people, from 1990 to 2030. Interpretation: PLC incidence along with case number are participated to increase at the global level through 2030. The increases in people afflicted by NASH and among older people suggest that the dearth of attention for these populations in current prevention strategies and highlighting their priority in the future schedules for global control of PLC. Funding: National Key Research and Development Program of China; National Natural Science Foundation of China; Science and Technology Commission of Shanghai Municipality; Shanghai Municipal Science and Technology Major Project. Declaration of Interest: We declare no conflicts of interest. Ethical Approval: Not Required.