Burden of Liver Cancer Attributable to Five Risk Factors by Specific Etiologies in 204 Countries and Territories

Abstract

Background Liver cancer has caused a serious disease burden worldwide wherein prognostic risk factors may have had a significant role. However, previous studies have focused on liver cancer distributions and trend variations without analyzing the role of risk factors. Methods We assessed liver cancer burden attributable to five recognized risk factors as well as temporal trends from 1990 to 2019 based on the 2019 Global Burden of Disease Study. The risk exposure levels and their contributed burden were estimated by cause, sex, age, and location. Furthermore, the relationship between the risks and social-demographic index (SDI) was investigated. Results The total liver cancer burden attributable to risk factors is still increasing year by year in terms of death and disability-adjusted life years. However, the burden attributable to alcohol use and smoking has shown a downward trend in recent years. Risk-related burden in males was more than three times as that in females, the burden among the middle-aged and elderly was the most serious, and Central Asia, high-income Asia Pacific and East Asia exhibited the highest burden worldwide. The exposure levels of the five recognized risk factors were generally positively correlated with SDI value. However, the risk-related liver cancer burden first increased and then decreased with the SDI value. Conclusion These findings could help in understanding the role of prognostic risk factors in liver cancer burden, in promoting the development of relevant studies, and in proposing better prevention and control policies tailored to local conditions.