To obtain trends and estimates of liver cancer by age, sex, region, and cause, Xingdong Chen, MD, PhD, of Fudan University in China, and his colleagues examined 1990-2017 data from the Global Burden of Disease Study pertaining to 195 countries and territories.

Globally, liver cancer cases diagnosed before the age of 30 years decreased from 17,381 in 1990 to 14,661 in 2017, but they increased in people aged 30-59 years and 60 years and older from 216,561 and 241,189 in 1990 to 359,770 and 578,344 in 2017, respectively. When applying age adjustments (to allow populations to be compared when the age profiles of the populations are different), the team found that the incidence of liver cancer diagnosed before age 30 years and from 30-59 years decreased in both sexes, whereas in older adults, rates increased in males and remained stable in females. Compared with women, men had a more dramatic increase in liver cancer diagnosed at aged 60 years and older and a milder decrease in cases diagnosed at 30-59 years.

Decreases seen in younger adults were largely ascribed to hepatitis B vaccinations (since the hepatitis B virus can cause liver cancer) and were consistent in most regions except in developed countries, in which liver cancer rates increased irrespective of sex and age. Liver cancer caused by non-alcoholic fatty liver disease, or buildup of fat in the liver, increased by the greatest magnitude in most regions.

"Our findings suggest the lack of attention for older people in current liver cancer prevention efforts and highlight the emerging concern of obesity as a risk factor for liver cancer," said Dr. Chen. "Liver cancer prevention strategies in both developing and developed countries should be tailored and updated."

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Journal Reference:

1. Zhenqiu Liu, Chen Suo, Xianhua Mao, Yanfeng Jiang, Li Jin, Tiejun Zhang, Xingdong Chen. Global incidence trends in primary liver cancer by age at diagnosis, sex, region, and etiology, 1990-2017. Cancer, 2020; DOI: 10.1002/cncr.32789