Global, regional and national burden of liver cancer in middle-aged and older adults from 1990 to 2021: a comprehensive analysis with cross-country inequality, decomposition, and frontier analysis
Weifan Sui, Yuxin Duan, Zefeng Cai, Yimao Xia, Jianyun Li, Jianhua FuBackground:
This study provides comprehensive estimates of the global, regional and national burden of liver cancer among middle-aged and older adults from 1990 to 2021, incorporating cross-country inequality assessment, decomposition of drivers, and frontier analysis.
Methods:
Age-standardized rates (ASRs) and estimated annual percentage changes (EAPCs) were utilized to quantify prevalence, incidence, deaths and disability-adjusted life years (DALYs) rates. Decomposition analysis, cross-country inequality assessment and frontier analysis were applied to dissect the burden dynamics.
Results:
In 2021, the absolute numbers of liver cancer prevalence, incidence, deaths, and DALYs all increased compared with 1990; however, age-standardized death and DALYs rates slightly decreased. The burden was consistently higher in males than in females. Population growth was the primary contributor to increased burden, while aging and epidemiological changes significantly contributed to burden reduction. A V-shaped relationship existed between DALYs rate and Socio-demographic Index (SDI). Significant absolute cross-country inequalities were observed. Fifteen countries demonstrated substantial potential for burden reduction.
Conclusion:
This study reveals complex dynamic changes in the global burden of liver cancer among people in middle-aged and older. Strengthening international cooperation, promoting equitable allocation of medical resources, and formulating differentiated strategies are essential future priorities.