Incidence trend of liver cancer associated with hepatitis C virus infection in China, 1990−2019

Objective To analyze the incidence of liver cancer associated with hepatitis C virus (HCV) infection in different age groups, periods and birth cohorts in China from 1990 to 2019, and provide reference for the prevention and control of liver cancer.

Methods The incidence data of liver cancer associated with HCV infection in China during this period were extracted from the global burden of disease 2019 database. Joinpoint regression was used to analyze the time trend of age-standardized incidence of liver cancer. Age-period-cohort model was used to analyze the effects of age, period and birth cohort on the incidence of liver cancer associated with HCV infection in China.

Results The results of Joinpoint regression analysis indicated that the standardized incidence rate of liver cancer associated with HCV infection decreased from 4.54/100 000 in 1990 to 1.75/100 000 in 2019, indicating a general downward trend (AAPC=−3.28%, P<0.001). However, the reduction in the standardized incidence rate in men (AAPC=−2.58%, P<0.001) was lower than that in women (AAPC=−3.71%, P<0.001). The analysis with age-period-cohort model found that the risk for liver cancer associated with HCV infection increased with age, the highest risk was observed in people aged 85-89 years (RR=7.54, 95%CI: 7.0–8.12). The curve of incidence risk also showed a “N” shape: increase, then decrease, and increase again. Moreover, the incidence risk decreased in later birth cohort, the all RR values in individuals born in 1949 or earlier were ＞1.00 (all P<0.001) and all RR values in individuals born in 1960 or later were ＜1.00 (all P<0.050).

Conclusion From 1990 to 2019, the incidence of HCV infection-related liver cancer in China showed a downward trend, but the decline was less obvious in recent years, and there were differences in the incidence of HCV infection-related liver cancer among different populations. It is suggested to strengthen health education in key populations, implement high-risk group screening, and provide timely intervention and treatment for early-stage HCV infections to reduce the burden of liver cancer in the future in China.