The Burden of Primary Liver Cancer and Underlying Etiologies From 1990 to 2015 at the Global, Regional, and National Level

Abstract

Global Burden of Disease Liver Cancer Collaboration IMPORTANCE Liver cancer is among the leading causes of cancer deaths globally. The most common causes for liver cancer include hepatitis B virus (HBV) and hepatitis C virus (HCV) infection and alcohol use.OBJECTIVE To report results of the Global Burden of Disease (GBD) 2015 study on primary liver cancer incidence, mortality, and disability-adjusted life-years (DALYs) for 195 countries or territories from 1990 to 2015, and present global, regional, and national estimates on the burden of liver cancer attributable to HBV, HCV, alcohol, and an "other" group that encompasses residual causes.DESIGN, SETTINGS, AND PARTICIPANTS Mortality was estimated using vital registration and cancer registry data in an ensemble modeling approach. Single-cause mortality estimates were adjusted for all-cause mortality. Incidence was derived from mortality estimates and the mortality-to-incidence ratio. Through a systematic literature review, data on the proportions of liver cancer due to HBV, HCV, alcohol, and other causes were identified. Years of life lost were calculated by multiplying each death by a standard life expectancy. Prevalence was estimated using mortality-to-incidence ratio as surrogate for survival. Total prevalence was divided into 4 sequelae that were multiplied by disability weights to derive years lived with disability (YLDs). DALYs were the sum of years of life lost and YLDs.MAIN OUTCOMES AND MEASURES Liver cancer mortality, incidence, YLDs, years of life lost, DALYs by etiology, age, sex, country, and year. RESULTS There were 854 000 incident cases of liver cancer and 810 000 deaths globally in 2015, contributing to 20 578 000 DALYs. Cases of incident liver cancer increased by 75% between 1990 and 2015, of which 47% can be explained by changing population age structures, 35% by population growth, and −8% to changing age-specific incidence rates. The male-to-female ratio for age-standardized liver cancer mortality was 2.8. Globally, HBV accounted for 265 000 liver cancer deaths (33%), alcohol for 245 000 (30%), HCV for 167 000 (21%), and other causes for 133 000 (16%) deaths, with substantial variation between countries in the underlying etiologies.CONCLUSIONS AND RELEVANCE Liver cancer is among the leading causes of cancer deaths in many countries. Causes of liver cancer differ widely among populations. Our results show that most cases of liver cancer can be prevented through vaccination, antiviral treatment, safe blood transfusion and injection practices, as well as interventions to reduce excessive alcohol use. In line with the Sustainable Development Goals, the identification and elimination of risk factors for liver cancer will be required to achieve a sustained reduction in liver cancer burden. The GBD study can be used to guide these prevention efforts.

Role of hepatoma‐derived growth factor in promoting de novo lipogenesis and tumorigenesis in hepatocellular carcinoma

“…The global incidence of liver cancer, especially in Asia, continues to rise, with China accounting for > 50% of the global burden (Petrick et al ., 2016; Uhlen et al ., 2017). The most common histological type of primary liver cancer is hepatocellular carcinoma (HCC) (Akinyemiju et al ., 2017). Studying the molecular mechanisms that lead to the development and progression of HCC is crucial for identifying new targets for early diagnosis and treatment.…”

Ablative techniques in hepatocellular carcinoma treatment

“…As the fourth leading cause of cancer related deaths in the world [3] , hepatocellular carcinoma remains one of the most feared complications of liver cirrhosis to date. The tremendously high case-fatality rate of this malignancy is often attributed to the relatively advanced stage of disease at the time of diagnosis in most cases [3,4] .…”

“…The tremendously high case-fatality rate of this malignancy is often attributed to the relatively advanced stage of disease at the time of diagnosis in most cases [3,4] . Although adoption of intensive surveillance programs for patients with underlying chronic liver disease have allowed for earlier detection of HCC [5] , prognosis remains poor for most patients, as evidenced by the short median survival following diagnosis, ranging from 6-20 months [6] .…”

Potential Molecular Targets and Drugs for Treatment of Hepatocellular Carcinoma

“…A total of 854,000 new cases of liver cancer and 810,000 related deaths were estimated in 2015. Globally, HBV accounted for 265000 liver cancer deaths (33%), alcohol for 245000 (30%), HCV for 167000 (21%), and other causes for 133000 (16%) deaths, with substantial variation between countries in the underlying etiologies [2]. For instance, in Africa and Asia, it is mainly due to endemic hepatitis B virus (HBV) infection, while hepatitis C virus (HCV), alcohol, nonalcoholic fatty liver disease are increasingly predominant causes in Western countries and Japan [3].…”