Epidemiological Trends and Projection of Liver Cancer Due to Nonalcoholic Steatohepatitis Among People Aged 55 Years and Older in China From 1990 to 2030: An Analysis of the Global Burden of Disease Study 2021.

Introduction: The aim of this study was to characterize the temporal trends of liver cancer due to metabolic dysfunction-associated steatohepatitis (LCDMDS) burden in China during 1990-2021; evaluate their age, period, and cohort effects; and predict the disease burden for the next 9 years.

Methods: Data were obtained from the Global Burden of Disease 2021 study. Joinpoint regression model was used to estimate the annual percentage change (APC) and the average APC of LCDMDS incidence and death rates, and the age-period-cohort analysis was used to estimate the age, period, and cohort effects. We extended the autoregressive integrated moving average (ARIMA) model to predict the disease burden of LCDMDS in 2022-2030.

Results: From 1990 to 2021, the number of incidence cases, incidence rates, number of deaths, and death rates of LCDMDS among the Chinese population aged 55 years and older all increased significantly. The number of incidence cases rose from 2,763 to 9,018, the incidence rate increased from 1.93 per 100,000 to 2.38 per 100,000, the number of deaths increased from 2,942 to 8,721, and the death rate rose from 2.05 per 100,000 to 2.30 per 100,000. The average APCs of the incidence rate and death rate were 0.72% ( P < 0.05) and 0.42% ( P > 0.05), respectively. Taking the average levels of age, period, and cohort as reference, the relative risks of LCDMDS incidence and death first increased and then decreased with age, increased over time, and decreased with the development of the birth cohort. The prediction results of the ARIMA model showed that the number of incidence cases and deaths among the Chinese population aged 55 years and older will continue to increase from 2022 to 2030, whereas the incidence rate and death rate will show slight changes.

Discussion: This study comprehensively explored the temporal trends of LCDMDS burden among Chinese aged 55 years and older from 1990 to 2021, revealing significant increases in incidence and mortality, as well as age, period, and cohort effects. ARIMA model projections show that the LCDMDS burden will continue to rise despite minor rate changes. Thus, immediate interventions such as early detection, public-health awareness-raising, and further research are urgently needed to relieve the LCDMDS burden in China.