Incidence and mortality trend of liver cancer in Iran from 1990 to 2021: an epidemiological investigation using the Global Burden of Disease study.

BACKGROUND

The burden of liver cancer across the world is one of the most concerning. Iran, as a developing country, lacks a comprehensive review of liver cancer burden in recent years. This study aimed to evaluate the changing burden of liver cancer in Iran from 1990 to 2021.

METHODS

Data were extracted from the Global Burden of Disease study. Age-standardized incidence and mortality rates (ASIR, ASMR) were the main metrics used in this study. Average annual percent change (AAPC) was calculated for Iran and each province.

RESULTS

Liver cancer incidence rate in Iran increased to 2.70 [2.39 to 3.04] per 100 000 population in 2021 with an AAPC of 0.85 [0.61 to 1.08]. Mortality of liver cancer in 2021 increased to 2.87 [2.55 to 3.23], representing an AAPC of 0.83 [0.32 to 1.35]. Men faced a higher burden than women. The burden of liver cancer became more prominent with increasing age. The Incidence of NASH-related liver cancer shifted remarkably during the studied time period, surpassing trends of other risk factors (AAPC: 1.89 [1.75 to 2.03]). Ardebil showed the most significant increasing trends in incidence and mortality rates compared to other provinces. Incidence of liver cancer remained low in lower SDI provinces but gradually increased when moving towards high SDI ones, suggesting a positive correlation.

CONCLUSION

This study highlights the concern for liver cancer rate and related death in Iran due to increasing shifts in mortality rates and deaths. Iranian policymakers must implement feasible preventive approaches to control liver cancer's major risk factors, such as NASH and Alcohol use.