Background
Liver cancer (LC) is considered as one of the most dominant malignant tumors which ranked 4th and in terms of global mortality and incidence, respectively. This work aimed to investigate the global temporal trends in LC mortality-to-incidence ratio (MIR) and its components, with a particular focus on examining long-term effect of human development index (HDI) on these metrics in a 30-year follow-up.
Methods
The age-standardized LC incidence and mortality data were derived from the global burden of disease (GBD) study 2019. We first leveraged joinpoint piecewise linear regression analysis to ascertain time trends in LC incidence, mortality, and MIR complement [1-MIR] and the average annual percentage change (AAPC) of the rates over the period 1990–2019. Then, the association between the metrics and HDI was explored through longitudinal multilevel models (LMMs).
Results
The incidence rates paralleled the mortality rates worldwide and they had similar significant monotonic decrementing trends with AAPC values of − 1.10% (95% confidence interval (CI): − 1.40, − 0.90%) and − 1.40% (− 1.50, − 1.30%), respectively from 1990 to 2019. The [1-MIR] rates were around 0 and showed an increasing pattern from 1.70 to 8.10 per 100,000 people (AAPC, 4.90%) at the same period of time. Results from the LMMs displayed that the majority of the variation lies at the country level accounted for about 88% of the total variance. Moreover, our analysis supported that the HDI was negatively associated with either incidence or mortality over time (p < 0.05).
Conclusions
Our findings highlighted that the global long-term temporal trends of LC incidence and mortality decreased slightly during 1990–2019 which may reflect improved therapeutic strategies and public health interventions. Besides, the low rates of [1-MIR] revealed the five-year relative survival rate was poor implying LC is diagnosed late in its development. Thereby, the policymakers’ focus must be on early screening and detection of liver cancer.
Aim of the studyFew population-based studies have been conducted to report the prevalence of non-alcoholic fatty liver disease (NAFLD) and determine its risk factors in Iran, particularly in Shahrekord, southwest Iran. The main aim of this population-based, case-control study was to determine the prevalence of NAFLD and its potential risk factors in an Iranian population-based cohort study in Shahrekord, Iran.Material and methodsWe compared 1153 cases with NAFLD at 35 to 70 years to 1153 frequency-matched NAFLD-free controls from a population-based Shahrekord cohort study. Data collection and assessed risk factors (demographics, anthropometrics, clinical and biochemical factors, and laboratory tests) were performed based on the Shahrekord cohort study protocol. Chi-square test, stepwise selection with backward likelihood ratio, logistic regression and log-binomial regression model with 95% confidence interval were performed to determine risk factors with significant effects on NAFLD.ResultsIn this study, the mean (± standard deviation) age of the participants was 50.23 (±8.70) years. The prevalence of NAFLD and metabolic syndrome with 95% confidence interval were 16.47% (15.61-17.36%) and 32.74% (30.83-34.70%), respectively. There was a significant difference in the frequency of waist circumstance, triglycerides, body mass index, blood pressure, and alanine aminotransferase between cases and controls (p < 0.001). According to log-binomial model results, socioeconomic status, hypertension, diabetes, and physical activity were significantly associated with NAFLD.ConclusionsOur findings have important clinical and public health implications in southwest Iran for monitoring the prevalence of NAFLD and important risk factors to manage, screen, prevent, and reduce NAFLD and related factors.
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