特定病因引起的原发性肝癌发病率趋势：2016 年全球疾病负担研究结果及其对肝癌预防的意义。
The trends in incidence of primary liver cancer caused by specific etiologies: Results from the Global Burden of Disease Study 2016 and implications for liver cancer prevention.
机构信息
State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Fudan University, Shanghai 200438, China; Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China; Key Laboratory of Public Health Safety (Fudan University), Ministry of Education, China; Fudan University Taizhou Institute of Health Sciences, Taizhou, China.
State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Fudan University, Shanghai 200438, China; Fudan University Taizhou Institute of Health Sciences, Taizhou, China.
出版信息
J Hepatol. 2019 Apr;70(4):674-683. doi: 10.1016/j.jhep.2018.12.001. Epub 2018 Dec 11.
BACKGROUND & AIMS: Liver cancer is a common malignant neoplasm worldwide. The etiologies for liver cancer are diverse and the incidence trends of liver cancer caused by specific etiologies are rarely studied. We therefore aimed to determine the pattern of liver cancer incidence, as well as temporal trends.
METHODS
We collected detailed information on liver cancer etiology between 1990-2016, derived from the Global Burden of Disease study in 2016. Estimated annual percentage changes (EAPCs) in liver cancer age standardized incidence rate (ASR), by sex, region, and etiology, were calculated to quantify the temporal trends in liver cancer ASR.
RESULTS
Globally, incident cases of liver cancer increased 114.0% from 471,000 in 1990 to 1,007,800 in 2016. The overall ASR increased by an average 0.34% (95% CI 0.22%-0.45%) per year in this period. The ASR of liver cancer due to hepatitis B, hepatitis C, and other causes increased between 1990 and 2016. The corresponding EAPCs were 0.22 (95% CI 0.08-0.36), 0.57 (95% CI 0.48-0.66), and 0.51 (95% CI 0.41-0.62), respectively. The ASR of liver cancer due to reported alcohol use remained stable (EAPC = 0.10, 95% CI -0.06-0.25). This increasing pattern was heterogeneous across regions and countries. The most pronounced increases were generally observed in countries with a high socio-demographic index, including the Netherlands, the UK, and the USA.
CONCLUSIONS
Liver cancer remains a major public health concern globally, though control of hepatitis B and C virus infections has contributed to the decreasing incidence in some regions. We observed an unfavorable trend in countries with a high socio-demographic index, suggesting that current prevention strategies should be reoriented, and much more targeted and specific strategies should be established in some countries to forestall the increase in liver cancer.
LAY SUMMARY
Liver cancer is a common malignant neoplasm worldwide. The incidence patterns of liver cancer caused by different etiologies varied considerably across the world. In this study, we aim to determine the pattern of liver cancer incidence as well as the temporal trends, thereby facilitating the establishment of more tailored prevention strategies for liver cancer.
背景与目的
肝癌是一种常见的恶性肿瘤，全球范围内均有发生。肝癌的病因多样，特定病因引起的肝癌发病率趋势鲜有研究。因此，我们旨在确定肝癌发病率的模式及时间趋势。
方法
我们收集了 1990 年至 2016 年间全球疾病负担研究中有关肝癌病因的详细信息。通过计算按性别、地区和病因划分的肝癌年龄标准化发病率（ASR）的年平均百分比变化（EAPC），量化了肝癌 ASR 的时间趋势。
结果
全球范围内，1990 年肝癌发病病例为 47.1 万例，2016 年增至 100.78 万例，增长了 114.0%。在此期间，肝癌的总体 ASR 平均每年增长 0.34%（95%CI 0.22%-0.45%）。1990 年至 2016 年期间，乙型肝炎、丙型肝炎和其他原因引起的肝癌 ASR 有所上升，相应的 EAPC 分别为 0.22（95%CI 0.08-0.36）、0.57（95%CI 0.48-0.66）和 0.51（95%CI 0.41-0.62）。报告的酒精使用引起的肝癌 ASR 保持稳定（EAPC=0.10，95%CI -0.06-0.25）。这种上升模式在各地区和国家之间存在差异。在高社会人口指数国家，包括荷兰、英国和美国，肝癌发病率的上升幅度最大。
结论
肝癌仍然是一个重大的全球公共卫生问题，尽管乙型肝炎和丙型肝炎病毒感染的控制已导致一些地区的肝癌发病率下降。在社会人口指数较高的国家，我们观察到了不利的趋势，这表明目前的预防策略应重新定位，一些国家应制定更有针对性和更具体的策略，以阻止肝癌的上升。
非专业人士仅供参考，如有错误，欢迎指正。
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