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Attributable Deaths of Liver Cancer in China
18 Pages Posted: 7 Apr 2021
More...Abstract
Background: Several risk factors of liver cancer have been identified through a number of epidemiological studies. However, there is little information about the contributions of these risk factors to liver cancer burden. We conducted a comparative study to estimate the liver cancer burden attributable to major risk factors of liver cancer deaths.
Methods: Liver cancer deaths for adults were estimated from 978 county-level surveillance points in China in 2014. Risk factors were identified from the International Agency for Research on Cancer and the World Cancer Research Fund International. Exposure prevalence of the studied risk factors was acquired from national representative surveys in China with a 10-year lag-period. Relative risks were obtained from recent high-quality meta-analyses in China. Population attributable fraction (PAF) by age, sex, and province was calculated using multiple formulas.
Findings: In China, 318 698 deaths from liver cancer were estimated, and 230 856 deaths were attributable to the studied risk factors, with a PAF of 72·4%. Hepatitis B virus (HBV) was responsible for the largest fraction of liver cancer burden in both genders (PAF=55·6% in males, and PAF=46·5% in females), followed by Hepatitis C virus (HCV) (PAF=17·4% in males, and PAF=15·9% in females). The PAFs for liver cancer burden in males attributable to smoking (PAF=15·7%), and alcohol drinking (PAF=10·3%) were significantly higher than in females (PAF=4·8% for smoking and PAF=1·6% for alcohol drinking). PAFs of HBV for liver cancer were particularly high across all age groups. The burden of HBV-attributable deaths was highest in Qinghai Province.
Interpretation: HBV still contributes to the majority of liver cancer burden than any other risk factors. Targeted preventive measures should be implemented based on the degree of contributions of different risk factors to liver cancer deaths.
Funding: This study was supported by the National Natural Science Foundation of China (81974492), Major State Basic Innovation Program of the Chinese Academy of Medical Sciences (2019-I2M-2-004), Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences (2019PT320027), and Sanming Project of Medicine in Shenzhen (SZSM201911015).
Declaration of Interest: None to declare.
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