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Background <p>Non-alcoholic fatty liver disease (NAFLD) and its advanced form, non-alcoholic steatohepatitis (NASH), significantly contribute to the increasing incidence of liver cancer due to NASH (NALC), emphasizing the urgent need to address the associated global health burden.</p> Methods <p>Using the Global Burden of Disease 2021 dataset, we analyzed the incidence, mortality, and disability-adjusted life year (DALY) rates of NALC and NAFLD from 1990 to 2021 across 204 countries. The Joinpoint model, age-period-cohort modeling, decomposition analysis, and frontier analysis were used to assess trends, identify contributing factors, and evaluate health inequities. Projections for future incidence were made using Nordpred and Bayesian age-period-cohort models.</p> Results <p>The global incidence and mortality rates of NALC have increased significantly. Incidence rose from 14,413.92 cases (95% CI 11,470.95–17,854.24) in 1990 to 42,291.37 (95% CI 34,032.64–51,129.45) in 2021. This trend was particularly evident in low-middle SDI countries, while high SDI countries exhibited declining mortality rates despite rising incidence. Population growth was a primary driver of the increased burden in most regions. Projections suggest that NALC incidence may reach 43,525.53 (95% CI 14,169.28–72,881.77) by 2039, particularly among the elderly, highlighting the serious future risks associated with NALC globally.</p> Conclusion <p>The findings highlight the growing global burden of NALC driven by NAFLD, especially in low- to middle-income regions. Targeted interventions, alongside a deeper understanding and better resource allocation, are essential to mitigate the rising incidence and address the health disparities associated with this expanding public health challenge.</p>

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Global, regional, and national burden of liver cancer due to non-alcoholic steatohepatitis and non-alcoholic fatty liver disease, 1990–2021: a multi-model trend analysis and forecasting study

  • 期刊论文

  • 发表日期：

    2025年2月12日

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  • Ti Yang,
  • Yang Lei,
  • Leyi Liao,
  • Chen Xie,
  • Xiangyue Mo,
  • Dongqing Cai,
  • Tianzhou Peng,
  • Yuancan Xiao,
  • Changhao Liu,
  • Qingping Li,
  • Jie Zhou,
  • Kai Wang,
  • Chuanjiang Li

摘要

Background

Non-alcoholic fatty liver disease (NAFLD) and its advanced form, non-alcoholic steatohepatitis (NASH), significantly contribute to the increasing incidence of liver cancer due to NASH (NALC), emphasizing the urgent need to address the associated global health burden.

Methods

Using the Global Burden of Disease 2021 dataset, we analyzed the incidence, mortality, and disability-adjusted life year (DALY) rates of NALC and NAFLD from 1990 to 2021 across 204 countries. The Joinpoint model, age-period-cohort modeling, decomposition analysis, and frontier analysis were used to assess trends, identify contributing factors, and evaluate health inequities. Projections for future incidence were made using Nordpred and Bayesian age-period-cohort models.

Results

The global incidence and mortality rates of NALC have increased significantly. Incidence rose from 14,413.92 cases (95% CI 11,470.95–17,854.24) in 1990 to 42,291.37 (95% CI 34,032.64–51,129.45) in 2021. This trend was particularly evident in low-middle SDI countries, while high SDI countries exhibited declining mortality rates despite rising incidence. Population growth was a primary driver of the increased burden in most regions. Projections suggest that NALC incidence may reach 43,525.53 (95% CI 14,169.28–72,881.77) by 2039, particularly among the elderly, highlighting the serious future risks associated with NALC globally.

Conclusion

The findings highlight the growing global burden of NALC driven by NAFLD, especially in low- to middle-income regions. Targeted interventions, alongside a deeper understanding and better resource allocation, are essential to mitigate the rising incidence and address the health disparities associated with this expanding public health challenge.