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| Trend and age-period-cohort analysis of the disease burden of liver cancer in China from 1990 to 2023 |
| WEI Yanlian1, NONG Sheng2, QI Guangzi1, JIANG Jianming2
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1. School of Public Health, Youjiang Medical University for Nationalities, Baise, Guangxi 533000, China;
2. School of Humanities and Management, Youjiang Medical University for Nationalities, Baise, Guangxi 533000, China |
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Abstract Objective To analyze the changing trend of liver cancer disease burden and its age, period and cohort effects in China from 1990 to 2023, so as to provide a basis for improving liver cancer prevention and treatment strategies. Methods Data on incidence, mortality, disability-adjusted life years (DALY), standardized incidence, standardized mortality, and standardized DALY rate of liver cancer in China from 1990 to 2023 were collected from the Global Burden of Disease (GBD) 2023 database. The trends in standardized incidence, standardized mortality, and standardized DALY rate of liver cancer were analyzed using the average annual percent change (AAPC). The effects of age, period, and birth cohort on the incidence, mortality, and DALY rate were evaluated using the age-period-cohort model. Results Standardized incidence, standardized mortality, and standardized DALY rate of liver cancer in China from 1990 to 2023 showed downward trends (AAPC=-1.009%, -1.275%, and -1.399%, all P<0.05). The age-period-cohort model showed that liver cancer incidence, mortality, and DALY rates increased and then decreased with age, and peaked in the groups aged 75-<80 years, 90-<95 years, and 65-<70 years, at 44.86/105, 50.88/105, and 908.28/105, respectively. Using the period 2000-2004 as the reference group, the risks of liver cancer incidence and mortality increased over time. Incidence risk was highest in 2020-2023 (RR=1.089, 95%CI: 1.078-1.099), and mortality risk was highest in 2015-2019 (RR=1.082, 95%CI: 1.075-1.089). Disability risk decreased over time, with the highest risk in 1995-1999 (RR=1.046, 95%CI: 1.044-1.049). Using the 1960-1964 birth cohort as the reference, incidence, mortality, and disability risks decreased with later birth cohorts. The 1920-1924 birth cohort had the highest incidence risk (RR=2.059, 95%CI: 1.988-2.132), mortality risk (RR=2.252, 95%CI: 2.191-2.315), and disability risk (RR=1.646, 95%CI: 1.625-1.668). Conclusions The overall burden of liver cancer in China showed a downward trend from 1990 to 2023, but the burden remained high among the elderly. The risks of incidence and mortality increased over time, while the risk of disability decreased. The risks of incidence, mortality, and disability all decreased with later birth years.
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Received: 11 December 2025
Revised: 05 April 2026
Published: 27 May 2026
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