[Disease Burden of Non-alcoholic Steatohepatitis-Associated Hepatocellular Carcinoma in China,the Globe,and Regions with Different Socio-Demographic Indices,1990-2021].

Abstract

Objective To analyze the disease burden and trends of non-alcoholic steatohepatitis-associated hepatocellular carcinoma (NASH-HCC) in China,the globe,and regions with varying socio-demographic indices (SDI) from 1990 to 2021,thus providing theoretical support for the prevention and control of NASH-HCC. Methods Using the Global Burden of Disease Study 2021 database,we assessed the age-standardized incidence rate,prevalence rate,mortality rate,disability-adjusted life years (DALYs),and other disease burden metrics for NASH-HCC,along with their trends.Decomposition analysis and frontier analysis were performed to evaluate influencing factors and regional disparities. Results From 1990 to 2021,the age-standardized incidence rate of NASH-HCC in the globe increased from 0.36 per 100 000 to 0.49 per 100 000,while that in China rose from 0.48 per 100 000 to 0.54 per 100 000.All burden indicators in China showed lower growth rates than the global average.The burden increased most significantly in high-SDI regions and decreased in low-SDI regions.Decomposition analysis revealed that population aging was the primary driver of burden changes in China,while epidemiological shifts were the main factor contributing to global prevalence changes.Frontier analysis indicated that China ranked in the middle globally in terms of the effective gap between its age-standardized mortality rate,age-standardized DALY rate,and the theoretically optimal prevention and control level. Conclusions The global disease burden of NASH-HCC keeps rising,with the most significant increase occurring in high-SDI regions.There are substantial disparities in prevention and control capabilities across regions with different SDI.Comprehensive public health policies,targeted interventions,and effective treatment strategies must be developed to further enhance prevention and control efficacy.