Burden of Hepatocellular Carcinoma and Its Underlying Etiologies in China, 1990-2021: Findings From the Global Burden of Disease Study 2021

PurposeThe incidence and mortality of hepatocellular carcinoma (HCC) and its underlying etiologies in China are still unclear. Therefore, this study used the Global Burden of Disease (GBD) 2021 to evaluate the incidence and mortality of HCC and its underlying etiologies in China.MethodsWe extracted the incident cases, incidence rate, deaths, and mortality rate of HCC and its underlying etiologies in China in 1990 and 2021 from the GBD database. In addition, we used joinpoint regression analysis to assess the trend of the incidence rate and mortality rate of HCC and its underlying etiologies in China from 1990 to 2021.ResultsThe incidence of HCC in China climbed from 96,434.35 in 1990 to 196,636.59 in 2021, while the number of deaths rose from 94,937.12 in 1990 to 172,068.40 in 2021. From 1990 to 2021, the age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) of HCC in China decreased by 0.31 (95% CI: 0.23, 0.39) and 0.79 (95% CI: 0.28, 1.30), respectively. ASIR demonstrated a decreasing trend in HCC caused by different etiologies, such as HCC due to hepatitis B (HCCDHB), HCC due to hepatitis C (HCCDHC), and HCC due to other causes (HCCDOC), but an increasing trend in HCC due to alcohol use (HCCDAU) and HCC due to NASH (HCCDNASH). Between 1990 and 2021, ASMR showed a downward trend in HCCDHB, HCCDHC, and HCCDOC, while the trend in HCCDAU and HCCDNASH was not significant.ConclusionsIn the past 30 years, although the overall incidence rate and mortality of HCC in China have declined, the proportion of HCCDAU and HCCDNASH has increased due to the increasingly serious problems of alcoholism and obesity. Therefore, interventions are needed to address the issues of alcohol consumption and obesity in order to control the incidence of HCCDAU and HCCDNASH.