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The Burden of Primary Liver Cancer and Underlying Etiologies From 1990 to 2015 at the Global, Regional, and National Level Results From the Global Burden of Disease Study 2015 Publisher Pubmed



Fitzmaurice C1, 9, 51 ; Akinyemiju T2 ; Abera S3, 4 ; Ahmed M5 ; Alam N6, 7 ; Alemayohu MA8 ; Allen C9 ; Alraddadi R10 ; Alvisguzman N11 ; Amoako Y12 ; Artaman A13 ; Ayele TA14 ; Barac A15 ; Bensenor I16 Show All Authors
Authors
  1. Fitzmaurice C1, 9, 51
  2. Akinyemiju T2
  3. Abera S3, 4
  4. Ahmed M5
  5. Alam N6, 7
  6. Alemayohu MA8
  7. Allen C9
  8. Alraddadi R10
  9. Alvisguzman N11
  10. Amoako Y12
  11. Artaman A13
  12. Ayele TA14
  13. Barac A15
  14. Bensenor I16
  15. Berhane A17
  16. Bhutta Z18, 19
  17. Castillorivas J20
  18. Chitheer A21
  19. Choi JY22
  20. Cowie B23
  21. Dandona L9, 24
  22. Dandona R9, 24
  23. Dey S25
  24. Dicker D9
  25. Phuc H26
  26. Ekwueme DU27
  27. Sayed Zaki M28
  28. Fischer F29
  29. Furst T30, 31, 32
  30. Hancock J9
  31. Hay SI9
  32. Hotez P33, 34
  33. Jee SH35
  34. Kasaeian A36
  35. Khader Y37
  36. Khang YH38
  37. Anil Kumar G39
  38. Kutz M9
  39. Larson H40
  40. Lopez A9, 41
  41. Lunevicius R42, 43
  42. Malekzadeh R44
  43. Mcalinden C45
  44. Meier T46
  45. Mendoza W47
  46. Mokdad A9, 49
  47. Moradilakeh M48
  48. Nagel G50
  49. Nguyen Q26
  50. Nguyen G9, 26
  51. Ogbo F52, 53
  52. Patton G54
  53. Pereira DM55
  54. Pourmalek F56
  55. Qorbani M57
  56. Radfar A58
  57. Roshandel G59
  58. Salomon JA60
  59. Sanabria J61, 62
  60. Sartorius B63
  61. Satpathy M64, 65
  62. Sawhney M66
  63. Sepanlou S44
  64. Shackelford K9
  65. Shore H68
  66. Sun J69
  67. Mengistu DT70
  68. Topormadry R71, 72
  69. Tran B73, 74
  70. Ukwaja KN75
  71. Vlassov V76
  72. Vollset SE77, 78
  73. Vos T9
  74. Wakayo T79
  75. Weiderpass E80, 81, 82
  76. Werdecker A83
  77. Yonemoto N84
  78. Younis M85, 86
  79. Yu C87
  80. Zaidi Z88, 89
  81. Zhu L67
  82. Murray CJL9
  83. Naghavi M9
Show Affiliations
Authors Affiliations
  1. 1. Division of Hematology, Department of Medicine, Institute for Health Metrics and Evaluation, University of Washington, 2301 Fifth Ave, Ste 600, Seattle, 98121, WA, United States
  2. 2. School of Public Health, Birmingham, University of Alabama at Birmingham, Akinyemiju, United States
  3. 3. Mekelle University, School of Public Health, College of Health Sciences, Mekelle, Tigray, Ethiopia
  4. 4. University of Hohenheim, Institute of Biological Chemistry and Nutrition, Stuttgart, Baden Wurttemberg, Germany
  5. 5. Jimma University, Institute of Health, Department of Epidemiology, Jimma, Oromiya, Ethiopia
  6. 6. Department of Health, Queensland Government, Herston, QLD, Australia
  7. 7. University of Queensland, School of Public Health, Herston, 30, QLD, Australia
  8. 8. Mekelle University Epidemiology, TNRS, Mekelle, Ethiopia
  9. 9. University of Washington, Institute for Health Metrics and Evaluation, Seattle, United States
  10. 10. Ministry of Health Research Department, Jeddah, Saudi Arabia
  11. 11. Universidad de Cartagena, Grupo de Investigacion en Economia de la Salud, Cartagena, Bolivar, Colombia
  12. 12. Komfo Anokye Teaching Hospital, Department of Medicine, Bantama, Ghana
  13. 13. University of Manitoba, Community Health Sciences, Winnipeg, MB, Canada
  14. 14. University of Gondar, Epidemiology and Biostatistics, Gondar, Ethiopia
  15. 15. Clinical Center of Serbia, Clinic for Infectious and Tropic Diseases, Belgrade, Serbia
  16. 16. Hospital Universitario, University of Sao Paulo, Division of Internal Medicine, Sao Paulo, Sao Paulo, Brazil
  17. 17. Debre Berhan University, College of Health Sciences, Debre Berhan, Amhara, Ethiopia
  18. 18. Aga Khan University, Centre of Excellence in Women and Child, Karachi, Sindh, Pakistan
  19. 19. Hospital for Sick Children, Centre for Global Child Health, Toronto, ON, Canada
  20. 20. Caja Costarricense de Seguro Social, Direccion Actuarial y Economica, San Jose, San Jose, Costa Rica
  21. 21. Iraq MOH FETP, MOH, Baghdad, Iraq
  22. 22. Seoul National University, College of Medicine Medical Library, Seoul, South Korea
  23. 23. Doherty Institute, WHO Collaborating Centre for Viral Hepatitis, Melbourne, VIC, Australia
  24. 24. Public Health Foundation of India Research, Gurgaon, NCR, India
  25. 25. Indian Institute of Public Health-Delhi, Environmental and Occupational Health, Gurgaon, Haryana, India
  26. 26. Duy Tan University, Institute for Global Health Innovations, Da Nang, Viet Nam
  27. 27. Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States
  28. 28. Clinical Pathology Department, Mansoura Faculty of Medicine, Mansoura, Egypt
  29. 29. Bielefeld University, School of Public Health, Bielefeld, Germany
  30. 30. Swiss Tropical and Public Health Institute, Epidemiology and Public Health, Basel, Switzerland
  31. 31. University of Basel, Switzerland
  32. 32. Imperial College London, School of Public Health, London, United Kingdom
  33. 33. Baylor College of Medicine, National School of Tropical Medicine, Houston, TX, United States
  34. 34. Sabin Vaccine Institute, Texas Children's Hospital Center for Vaccine Development, Houston, United States
  35. 35. Graduate School of Public Health, Yonsei University, Epidemiology and Health Promotion, Seoul, South Korea
  36. 36. Tehran University of Medical Sciences, Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran, Tehran, Iran
  37. 37. Jordan University of Science and Technology, Public Health, Irbid, Irbid, Jordan
  38. 38. Seoul National University, College of Medicine, Institute of Health Policy and Management, Seoul, Seoul Metropolitan City, South Korea
  39. 39. Public Health Foundation of India Research, Gurgaon (NCR), Haryana, India
  40. 40. Department Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
  41. 41. University of Melbourne, Melbourne School of Population and Global Health, Melbourne, VIC, Australia
  42. 42. Aintree University Hospital NHS Foundation Trust, General Surgery Department, Liverpool, United Kingdom
  43. 43. School of Medicine, University of Liverpool, Liverpool, United Kingdom
  44. 44. Tehran University of Medical Sciences, Digestive Diseases Research Institute, Tehran, Iran
  45. 45. University Hospitals Bristol, Department of Medicine, Bristol, United Kingdom
  46. 46. Martin Luther University Halle-Wittenberg, Institute for Agricultural and Nutritional Sciences, Halle (Saale), Germany
  47. 47. UNFPA Peru Country Office, Lima, Peru
  48. 48. Iran University of Medical Sciences, Gastrointestinal and Liver Disease Research Center, Tehran, Iran
  49. 49. Iran University of Medical Sciences, Preventive Medicine and Public Health Research Center, Tehran, Iran
  50. 50. Ulm University, Institute of Epidemiology and Medical Biometry, Ulm, Germany
  51. 51. Division of Hematology, Department of Medicine, University of Washington, Seattle, United States
  52. 52. Western Sydney University, Centre for Health Research, School of Medicine, Penrith, NSW, Australia
  53. 53. Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
  54. 54. University of Melbourne, Paediatrics, Melbourne, VIC, Australia
  55. 55. REQUIMTE/LAQV, Laboratorio deFarmacognosia, Departamento deQuimica, Faculdade de Farmacia, Universidade do Porto, Porto, Portugal
  56. 56. Department of Urology, University of British Columbia, Vancouver, BC, Canada
  57. 57. Alborz University of Medical Sciences, Noncommunicable Diseases Research Center, Karaj, Alborz, Iran
  58. 58. A.T. Still University, College of Graduate Health Studies, Mesa, AZ, United States
  59. 59. Golestan University of Medical Sciences, Golestan Research Center of Gastroenterology and Hepatology, Gorgan, Iran
  60. 60. Harvard T.H. Chan School of Public Health, Department of Global Health and Population, Boston, MA, United States
  61. 61. Marshall University School of Medicine, Surgery, Huntington, WV, United States
  62. 62. Case Western Reserve University, Nutrition and Preventive Medicine, OH, United States
  63. 63. University of KwaZulu-Natal, Public Health Medicine, Durban, KwaZulu-Natal, South Africa
  64. 64. Utkal University, Centre for Advanced Study in Psychology, Bhubaneswar, Odisha, India
  65. 65. AIIMS New Delhi, JPN Apex Trauma Centre, New Delhi, Delhi, India
  66. 66. Marshall University Public Health, Huntington, WV, United States
  67. 67. Jiangsu Provincial Center for Disease Control and Prevention, Major Project Execution Office, Nanjing, Jiangsu, China
  68. 68. Haramaya University, School of Public Health, Harari, Ethiopia
  69. 69. Queensland University of Technology, School of Public Health and Social Work, Brisbane, QLD, Australia
  70. 70. Mekelle University, Institute of Biomedical Sciences, Mekelle, Tigrai, Ethiopia
  71. 71. Faculty of Health Sciences, Jagiellonian University Medical College, Institute of Public Health, Krakow, Poland
  72. 72. Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland
  73. 73. Hanoi Medical University, Institute for Preventive Medicine and Public Health, Hanoi, Viet Nam
  74. 74. Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, United States
  75. 75. Federal Teaching Hospital, Department of Medicine, Abakaliki, Ebonyi State, Nigeria
  76. 76. Department of Health Care Administration and Economy, National Research University Higher School of Economics, Moscow, Russian Federation
  77. 77. Norwegian Institute of Public Health, Centre for Disease Burden, Bergen, Norway
  78. 78. University of Bergen, Department of Global Public Health and Primary Care, Bergen, Norway
  79. 79. Jimma University, Population and Family Health, Oromia, Ethiopia
  80. 80. Cancer Registry of Norway, Institute of Population Based Cancer Research, Oslo, Norway
  81. 81. University of Tromso, Arctic University of Norway, Department of Community Medicine, Faculty of Health Sciences, Tromso, Norway
  82. 82. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
  83. 83. Federal Institute for Population Research, Competence Center Mortality-Follow-Up of the National Cohort, Wiesbaden, Hesse, Germany
  84. 84. Kyoto University, School of Public Health Biostatistics, Sakyo, Kyoto, Japan
  85. 85. Jackson State University, Health Policy and Management, Jackson, MS, United States
  86. 86. Harvard Asia Aging Center, Harvard Medical School, Boston, MA, United States
  87. 87. Department of Epidemiology and Biostatistics, Wuhan University, Wuhan, Hubei Province, China
  88. 88. Department of Epidemiology, University Hospital of Setif, Setif, Algeria
  89. 89. University Ferhat Abbas, Faculty of Medicine, Setif, Algeria

Source: JAMA Oncology Published:2017


Abstract

IMPORTANCE: Liver cancer is among the leading causes of cancer deaths globally. The most common causes for liver cancer include hepatitis B virus (HBV) and hepatitis C virus (HCV) infection and alcohol use. OBJECTIVE: To report results of the Global Burden of Disease (GBD) 2015 study on primary liver cancer incidence, mortality, and disability-adjusted life-years (DALYs) for 195 countries or territories from 1990 to 2015, and present global, regional, and national estimates on the burden of liver cancer attributable to HBV, HCV, alcohol, and an other group that encompasses residual causes. DESIGN, SETTINGS, AND PARTICIPANTS: Mortality was estimated using vital registration and cancer registry data in an ensemble modeling approach. Single-cause mortality estimates were adjusted for all-cause mortality. Incidence was derived from mortality estimates and the mortality-to-incidence ratio. Through a systematic literature review, data on the proportions of liver cancer due to HBV, HCV, alcohol, and other causes were identified. Years of life lost were calculated by multiplying each death by a standard life expectancy. Prevalence was estimated using mortality-to-incidence ratio as surrogate for survival. Total prevalence was divided into 4 sequelae that were multiplied by disability weights to derive years lived with disability (YLDs). DALYs were the sum of years of life lost and YLDs. MAIN OUTCOMESAND MEASURES: Liver cancer mortality, incidence, YLDs, years of life lost, DALYs by etiology, age, sex, country, and year. RESULTS: There were 854 000 incident cases of liver cancer and 810 000 deaths globally in 2015, contributing to 20 578 000 DALYs. Cases of incident liver cancer increased by 75% between 1990 and 2015, of which 47% can be explained by changing population age structures, 35% by population growth, and -8% to changing age-specific incidence rates. The male-to-female ratio for age-standardized liver cancer mortality was 2.8. Globally, HBV accounted for 265 000 liver cancer deaths (33%), alcohol for 245 000 (30%), HCV for 167 000 (21%), and other causes for 133 000 (16%) deaths, with substantial variation between countries in the underlying etiologies. CONCLUSIONS AND RELEVANCE: Liver cancer is among the leading causes of cancer deaths in many countries. Causes of liver cancer differ widely among populations. Our results show that most cases of liver cancer can be prevented through vaccination, antiviral treatment, safe blood transfusion and injection practices, as well as interventions to reduce excessive alcohol use. In line with the Sustainable Development Goals, the identification and elimination of risk factors for liver cancer will be required to achieve a sustained reduction in liver cancer burden. The GBD study can be used to guide these prevention efforts.
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