ObjectiveTo analyze the incidence and mortality of cirrhosis in China from 1992 to 2021, and to explore the impacts of age, period, and birth cohort factors on the incidence and mortality of cirrhosis. MethodsBy means of the Global Burden of Disease (GBD) 2021 database, the incidence and mortality of cirrhosis in China from 1992 to 2021 were analyzed. The Joinpoint software was used to analyze the temporal trends of the standardized incidence rate and standardized mortality rate of cirrhosis, and the average annual percentage change was calculated. An age-period-cohort model was constructed to deeply explore the effects of age, period, and birth cohort factors on the changing trends of the incidence and mortality of cirrhosis. ResultsIn 2021, the incidence of cirrhosis in China was 772.07 per 100 000, and the mortality was 10.99 per 100 000, representing decreases of 5.53% and 26.98%, respectively, compared with 1992. By gender, in 2021, the incidence of cirrhosis in males (727.95 per 100 000) was lower than that in females (818.32 per 100 000), but the mortality in males (15.53 per 100 000) was higher than that in females (6.24 per 100 000). From 1992 to 2021, the age-standardized incidence rate (ASIR) of cirrhosis in China showed a decreasing trend, with an average annual decrease of 0.31%, which was statistically significant (P=0.014). Similarly, the age-standardized mortality rate (ASMR) of cirrhosis also showed a decreasing trend, with an average annual decrease of 3.21%, which was statistically significant (P=0.021). The age effect results showed that the incidence of cirrhosis in China generally followed a trend of first decreasing, then increasing, and then decreasing again. There was a significant downward trend in incidence in the 5–14 years old group, a significant upward trend in the 15–24 years old group, and a fluctuating downward trend after 25 years old. Mortality rates gradually increased, from 2.32 per 100 000 in the 0–4 years old group to 27.72 per 100 000 in the 85–89 years old group. The period effect results showed that the period relative risk (RR) for cirrhosis incidence first decreased and then increased, with the highest risk from 1992 to 1996 [RR=1.19, 95%CI (1.10, 1.29)]. The period RR for cirrhosis mortality showed a decreasing trend, with the highest mortality risk occurring from 1992 to 1996 [RR=1.41, 95%CI (1.36, 1.45)]. The cohort effect results indicated that the later the birth cohort, the lower the risk of cirrhosis incidence and mortality. In 2021, among the five types of cirrhosis, nonalcoholic fatty liver disease (NAFLD)-induced cirrhosis had the highest incidence (672.02 per 100 000), while cirrhosis caused by hepatitis B had the highest mortality (8.15 per 100 000). From 1992 to 2021, alcohol-related cirrhosis showed the most significant increase in incidence (37.50%), and NAFLD-induced cirrhosis showed the most significant increase in mortality (25.00%). ConclusionsFrom 1992 to 2021, the ASIR and ASMR of cirrhosis in China show a declining trend. Age, period, and cohort all have significant effects on the trends of cirrhosis incidence and mortality. NAFLD-induced cirrhosis has the highest incidence, while cirrhosis caused by hepatitis B has the highest mortality.
Objective To analyze the incidence and mortality of liver cancer in China between 1992 and 2021, in order to provide data support for the prevention and treatment of liver cancer in the country. MethodsUsing the Global Burden of Disease (2021) database, we analyzed the trends and performed an age-period-cohort model analysis on the incidence and mortality of liver cancer by gender in China between 1992 and 2021. An autoregressive integrated moving average model was employed to forecast the age-standardized incidence and mortality rates of liver cancer in China from 2022 to 2030. ResultsCompared with 1992, the number of incident cases and deaths from liver cancer in China in 2021 increased significantly in the total population, males, and females. The percentage changes in the number of cases were 93.98% (101 400→196 700), 94.06% (74 100→143 800), and 93.41% (27 300→52 800), respectively. The corresponding percentage changes in the number of deaths were 75.25% (98 200→172 100), 72.29% (71 100→122 500), and 83.70% (27 000→49 600). The rate of change in incidence for the total population, males, and females in 2021 was 64.33% (8.41 per 100 000→13.82 per 100 000), 66.11% (11.89 per 100 000→19.75 per 100 000), and 62.61% (4.68 per 100 000→7.61 per 100 000), respectively; the rate of change in mortality was 48.53% (8.14 per 100 000→12.09 per 100 000), 47.41% (11.41 per 100 000→16.82 per 100 000), and 53.88% (4.64 per 100 000→7.14 per 100 000), respectively. The standardized incidence rates decreased compared to 1992, with changes of –9.16% (10.48 per 100 000→9.52 per 100 000), –4.14% (14.96 per 100 000→14.34 per 100 000), and –17.54% (5.93 per 100 000→4.89 per 100 000) for the total population, males, and females, respectively; the standardized mortality rates decreased by –20.32% (10.48 per 100 000→8.35 per 100 000), –16.61% (14.87 per 100 000→12.40 per 100 000), and –24.84% (6.08 per 100 000→4.57 per 100 000), respectively. The age effect showed significant variations in liver cancer risk with age, with the highest incidence risk in the 65–69 age group for the total population and females, and the 60–64 age group for males. The period effect overall showed an upward trend, with the most significant increase occurring from 2017 to 2021. The cohort effect indicated significant variations in liver cancer risk across different birth cohorts, with an overall increasing trend for the total population and females born between 1907 and 1981, and the most significant risk increase for males born between 1952 and 1956. The incidence and mortality risk for those born between 2017 and 2021 showed a significant downward trend. The prediction results indicated a continuous decline in liver cancer incidence and mortality rates for the total population, males, and females in China from 2022 to 2030. ConclusionsFrom 1992 to 2021, the incidence and mortality rates of liver cancer in China increased, while the standardized incidence and mortality rates showed a decreasing trend. Age, period, and cohort are significant factors influencing liver cancer. It is essential to further strengthen liver cancer prevention and control strategies and vaccine implementation.
