Disability adjusted life years for liver cancer in China: trend analysis from 1990 to 2016 and future prediction_Chinese Journal of Evidence-Based Medicine

Authors：

RAN Jianchao ^1,2 ^# , WANG Le ¹ ^# , ZHANG Yue ³ , ZHU Juan ¹ , HUANG Jiawen ¹ , BAI Fangzhou ¹ , ZHAO Jianjun ⁴ , HAN Youli ⁵ , QU Chunfeng ⁶ , DAI Min ¹ ,  ZHU Lin ⁷ ,  SHI Jufang ¹

1. Office of Cancer Screening, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, P.R.China;
2. School of Public Health, Xinjiang Medical University, Urumqi, 830011, P.R.China;
3. Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, 100026, P.R.China;
4. Department of Abdominal Surgical Oncology, National Cancer Center/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, P.R.China;
5. School of Health Management and Education, Capital Medical University, Beijing, 100069, P.R.China;
6. Department of Immunology/State Key Lab of Molecular Oncology, National Cancer Center / Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, P.R.China;
7. The Third Clinical Medical College of Xinjiang Medical University, Urumqi, 830011, P.R.China ;

Corresponding author：

ZHU Lin, Email: zhulintt2002@126.com; SHI Jufang, Email: shijf@cicams.ac.cn

Keywords：

Liver cancer; Burden of disease; DALYs; Attribution; Prediction; China

DOI：

10.7507/1672-2531.201802024

Video：

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ObjectivesTo estimate the latest burden of disability adjusted life years (DALYs) for liver cancer in China and the long-term trend, and to make future prediction.MethodsBased on the visualization platform of Global Burden of Disease 2016, data on the DALYs for liver cancer in China was extracted. The very recent status in 2016 and the previous trend from 1990 to 2016 were described, using annualized rate of change (ARC). The burden from 2017 to 2050 was further predicted by combining the ARC and the Chinese population data projected by the United Nation.ResultsIn 2016, the total DALYs for liver cancer in China was estimated as 11 539 000 person years (accounting for 54.6% of the global burden), and years of life lost (YLLs) and years lived with disability (YLDs) contributed 98.9% and 1.1%, respectively. The age-standardized DALY rate was 844.1 per 100 000 (3.0 times of the global average) and the male-to-female ratio was 3.4. The DALY rate continuously increased from 1990–2016 (ARC=0.57%), particularly in recent 5 years (ARC=1.75%). Among the DALYs for all cancers, liver cancer contributed approximately 20% and constantly remained as the top 2 (ranking as the number one before year 2005). There were inverse trends in gender, with increasing in males and decreasing in females (ARC was 0.77% and –0.11%, respectively). Hepatitis B infection continually kept the leading cause of DALYs for liver cancer (accounting for nearly 57%), and the DALY rate was gradually increasing (ARC=0.43%). Although the peak age of DALY rate was stable at 65to 69 years, the peak age of the DALYs changed from 55 to 59 years in 1990 to 60 ~ 64 years in 2016. In 2050, the estimated DALYs for liver cancer in China will reach 14.37 million person years, 20.0% more than that in 2017.ConclusionsThe DALYs caused by liver cancer in China exceeds the overall burden of all other countries in the world, and accounts for 1/5 of DALYs for all cancers in local population. The burden in males has been continuously rising, and the leading cause remained unchanged as hepatitis B infection. With population aging, the DALYs for liver cancer in China will be incessant to increase, suggesting the necessity to implement continuous effort in risk factors prevention (e.g. hepatitis B infection), and efficient management in high risk population of liver cancer.

Citation： RAN Jianchao, WANG Le, ZHANG Yue, ZHU Juan, HUANG Jiawen, BAI Fangzhou, ZHAO Jianjun, HAN Youli, QU Chunfeng, DAI Min, ZHU Lin, SHI Jufang. Disability adjusted life years for liver cancer in China: trend analysis from 1990 to 2016 and future prediction. Chinese Journal of Evidence-Based Medicine, 2018, 18(5): 401-409. doi: 10.7507/1672-2531.201802024 Copy

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2.	石菊芳, 张玥, 曲春枫, 等. 以伤残调整生命年为指标的中国人群癌症疾病负担现状. 中华预防医学杂志, 2015, 49(4): 365-369.
3.	GBD 2016 DALYs and HALE Collaborators. Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990–2016: a systematic analysis for the global burden of disease study 2016. Lancet, 2017, 390(10100): 1260.
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5.	张玥, 石菊芳, 黄慧瑶, 等. 中国人群结直肠癌疾病负担分析. 中华流行病学杂志, 2015, 36(7): 709-714.
6.	王乐, 张玥, 石菊芳, 等. 中国女性乳腺癌疾病负担分析. 中华流行病学杂志, 2016, 37(7): 970-976.
7.	王黎君, 殷鹏, 刘韫宁, 等. 1990 年与 2013 年中国人群肝癌疾病负担研究. 中华流行病学杂志, 2016, 37(6): 758-762.
8.	石菊芳, 赵琨, 曲春枫, 等. 肝癌筛查相关卫生技术评估. 中国循证医学杂志, 2018, 18(5): 397-400.
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12.	陈彦, 陈刚. 对 2015 年全球疾病负担研究及我国现状的系统分析——Lancet 全球疾病负担研究摘译. 福建医药杂志, 2017, 39(3): 1-12.
13.	Institute for Health Metrics and Evaluation, University of Washington. GHDx. Available at: http://ghdx.healthdata.org/geography/china.
14.	Zhou M, Wang H, Zhu J, et al. Cause-specific mortality for 240 causes in China during 1990–2013: a systematic subnational analysis for the global burden of disease study 2013. Lancet, 2016, 387(10015): 251.
15.	United Nations, Department of Economic and Social Affairs, Population Division. World Population Prospects 2017. Available at: https://esa.un.org/unpd/wpp/Download/Standard/Population/.
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17.	张玥, 曲春枫, 任建松, 等. 中国肝癌发病与死亡数据集. 中华肿瘤杂志, 2015, 37(9): 705-720.
18.	郑荣寿, 左婷婷, 曾红梅, 等. 中国肝癌死亡状况与生存分析. 中华肿瘤杂志, 2015, 37(9): 697-702.
19.	左婷婷, 郑荣寿, 曾红梅, 等. 中国肝癌发病状况与趋势分析. 中华肿瘤杂志, 2015, 37(9): 691-696.
20.	Zeng HM, Zheng RS, Guo Y, et al. Cancer survival in China, 2003-2005: a population-based study. Int J Cancer, 2015, 136(8): 1921.
21.	National Cancer Institute. Cancer statistics. 2014. Available at: https://seer.cancer.gov/statfacts/html/livibd.html.
22.	彭慧, 郑莹, 彭鹏,等. 上海市人群 2002～2006 年肝癌生存率分析. 中国癌症杂志, 2016, 26(7):561-568.
23.	Shih ST, Crowley S, Sheu JC. Cost-effectiveness analysis of a two-stage screening intervention for hepatocellular carcinoma in Taiwan. J Formos Med Assoc, 2010, 109(1): 39-55.
24.	陈万青, 郑荣寿, 张思维, 等. 2013 年中国恶性肿瘤发病和死亡分析. 中国肿瘤, 2017, 26(1): 1-7.
25.	Fan JH, Wang JB, Liang H, et al. Attributable causes of liver cancer mortality and incidence in China. Asian Pac J Cancer Prev, 2013, 14(12): 7251.
26.	Wang M, Wang Y, Feng X, et al. Contribution of hepatitis B virus and hepatitis C virus to liver cancer in China north areas: experience of the Chinese national cancer center. Int J Infect Dis, 2017, 65:15.
27.	Qu C, Duan Z, Chen K, et al. Reducing liver cancer risk beginning at birth: experiences of preventing chronic hepatitis B virus infection in China. Hepatoma Res, 2017, 3(10): 228-240.
28.	王富珍, 张国民, 沈立萍, 等. 1992 和 2014 年中国不同流行地区 1～29 岁人群乙型肝炎血清流行病学调查结果对比分析. 中华预防医学杂志, 2017, 51(6): 462-468.
29.	Qu C, Chen T, Fan C, et al. Efficacy of neonatal HBV vaccination on liver cancer and other liver diseases over 30-year follow-up of the Qidong hepatitis B intervention study: a cluster randomized controlled trial. PLoS Med, 2014, 11(12): e1001774.
30.	Chong CC, Wong GL, Wong VW, et al. Antiviral therapy improves post-hepatectomy survival in patients with hepatitis B virus-related hepatocellular carcinoma: a prospective-retrospective study. Aliment Pharmacol Ther, 2015, 41(2):199-208.
31.	Wang Y, Chen T, Lu LL, et al. Adolescent booster with hepatitis B virus vaccines decreases HBV infection in high-risk adults. Vaccine, 2017, 35(7): 1064-1070.
32.	Guirguis J, Chhatwal J, Dasarathy J, et al. Clinical impact of alcohol-related cirrhosis in the next decade: estimates based on current epidemiological trends in the United States. Alcohol Clin Exp Res, 2015, 39(11): 2085-2094.
33.	World Health Organization. Global strategy to reduce harmful use of alcohol. Available at: http://www.who.int/substance_abuse/activities/gsrhua/en/.
34.	Islami F, Chen W, Yu XQ, et al. Cancer deaths and cases attributable to lifestyle factors and infections in China, 2013. Ann Oncol, 2017, 28(10): 2567-2574.
35.	Craxi A, Pawlotsky JM, Wedemeyer H, et al. EASL clinical practice guidelines: management of hepatitis C virus infection. J Hepatol, 2011, 55(2): 245-264.

1. Ferlay J, Soerjomataram I, Ervik M, et al. GLOBOCAN 2012 v1.0, Cancer incidence and mortality worldwide: IARC CancerBase No.11. Available at: http://globocan.iarc.fr.
2. 石菊芳, 张玥, 曲春枫, 等. 以伤残调整生命年为指标的中国人群癌症疾病负担现状. 中华预防医学杂志, 2015, 49(4): 365-369.
3. GBD 2016 DALYs and HALE Collaborators. Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990–2016: a systematic analysis for the global burden of disease study 2016. Lancet, 2017, 390(10100): 1260.
4. 冯雅靖, 王宁, 方利文, 等. 1990 年与 2013 年中国人群结直肠癌疾病负担分析. 中华流行病学杂志, 2016, 37(6): 768-772.
5. 张玥, 石菊芳, 黄慧瑶, 等. 中国人群结直肠癌疾病负担分析. 中华流行病学杂志, 2015, 36(7): 709-714.
6. 王乐, 张玥, 石菊芳, 等. 中国女性乳腺癌疾病负担分析. 中华流行病学杂志, 2016, 37(7): 970-976.
7. 王黎君, 殷鹏, 刘韫宁, 等. 1990 年与 2013 年中国人群肝癌疾病负担研究. 中华流行病学杂志, 2016, 37(6): 758-762.
8. 石菊芳, 赵琨, 曲春枫, 等. 肝癌筛查相关卫生技术评估. 中国循证医学杂志, 2018, 18(5): 397-400.
9. Institute for Health Metrics and Evaluation, University of Washington. GBD Compare. 2018. Available at: https://vizhub.healthdata.org/gbd-compare/.
10. GBD Causes of Death Collaborators. Global, regional, and national age-sex specific mortality for 264 causes of death, 1980–2016: a systematic analysis for the global burden of disease study 2016. Lancet, 2017, 390(10100): 1151.
11. GBD 2016 Risk Factors Collaborators. Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2016: a systematic analysis for the global burden of disease study 2016. Lancet, 2017, 390(10100): 1345-1422.
12. 陈彦, 陈刚. 对 2015 年全球疾病负担研究及我国现状的系统分析——Lancet 全球疾病负担研究摘译. 福建医药杂志, 2017, 39(3): 1-12.
13. Institute for Health Metrics and Evaluation, University of Washington. GHDx. Available at: http://ghdx.healthdata.org/geography/china.
14. Zhou M, Wang H, Zhu J, et al. Cause-specific mortality for 240 causes in China during 1990–2013: a systematic subnational analysis for the global burden of disease study 2013. Lancet, 2016, 387(10015): 251.
15. United Nations, Department of Economic and Social Affairs, Population Division. World Population Prospects 2017. Available at: https://esa.un.org/unpd/wpp/Download/Standard/Population/.
16. Stanaway JD, Flaxman AD, Naghavi M, et al. The global burden of viral hepatitis from 1990 to 2013: findings from the global burden of disease study 2013. Lancet, 2016, 388(10049):1081.
17. 张玥, 曲春枫, 任建松, 等. 中国肝癌发病与死亡数据集. 中华肿瘤杂志, 2015, 37(9): 705-720.
18. 郑荣寿, 左婷婷, 曾红梅, 等. 中国肝癌死亡状况与生存分析. 中华肿瘤杂志, 2015, 37(9): 697-702.
19. 左婷婷, 郑荣寿, 曾红梅, 等. 中国肝癌发病状况与趋势分析. 中华肿瘤杂志, 2015, 37(9): 691-696.
20. Zeng HM, Zheng RS, Guo Y, et al. Cancer survival in China, 2003-2005: a population-based study. Int J Cancer, 2015, 136(8): 1921.
21. National Cancer Institute. Cancer statistics. 2014. Available at: https://seer.cancer.gov/statfacts/html/livibd.html.
22. 彭慧, 郑莹, 彭鹏,等. 上海市人群 2002～2006 年肝癌生存率分析. 中国癌症杂志, 2016, 26(7):561-568.
23. Shih ST, Crowley S, Sheu JC. Cost-effectiveness analysis of a two-stage screening intervention for hepatocellular carcinoma in Taiwan. J Formos Med Assoc, 2010, 109(1): 39-55.
24. 陈万青, 郑荣寿, 张思维, 等. 2013 年中国恶性肿瘤发病和死亡分析. 中国肿瘤, 2017, 26(1): 1-7.
25. Fan JH, Wang JB, Liang H, et al. Attributable causes of liver cancer mortality and incidence in China. Asian Pac J Cancer Prev, 2013, 14(12): 7251.
26. Wang M, Wang Y, Feng X, et al. Contribution of hepatitis B virus and hepatitis C virus to liver cancer in China north areas: experience of the Chinese national cancer center. Int J Infect Dis, 2017, 65:15.
27. Qu C, Duan Z, Chen K, et al. Reducing liver cancer risk beginning at birth: experiences of preventing chronic hepatitis B virus infection in China. Hepatoma Res, 2017, 3(10): 228-240.
28. 王富珍, 张国民, 沈立萍, 等. 1992 和 2014 年中国不同流行地区 1～29 岁人群乙型肝炎血清流行病学调查结果对比分析. 中华预防医学杂志, 2017, 51(6): 462-468.
29. Qu C, Chen T, Fan C, et al. Efficacy of neonatal HBV vaccination on liver cancer and other liver diseases over 30-year follow-up of the Qidong hepatitis B intervention study: a cluster randomized controlled trial. PLoS Med, 2014, 11(12): e1001774.
30. Chong CC, Wong GL, Wong VW, et al. Antiviral therapy improves post-hepatectomy survival in patients with hepatitis B virus-related hepatocellular carcinoma: a prospective-retrospective study. Aliment Pharmacol Ther, 2015, 41(2):199-208.
31. Wang Y, Chen T, Lu LL, et al. Adolescent booster with hepatitis B virus vaccines decreases HBV infection in high-risk adults. Vaccine, 2017, 35(7): 1064-1070.
32. Guirguis J, Chhatwal J, Dasarathy J, et al. Clinical impact of alcohol-related cirrhosis in the next decade: estimates based on current epidemiological trends in the United States. Alcohol Clin Exp Res, 2015, 39(11): 2085-2094.
33. World Health Organization. Global strategy to reduce harmful use of alcohol. Available at: http://www.who.int/substance_abuse/activities/gsrhua/en/.
34. Islami F, Chen W, Yu XQ, et al. Cancer deaths and cases attributable to lifestyle factors and infections in China, 2013. Ann Oncol, 2017, 28(10): 2567-2574.
35. Craxi A, Pawlotsky JM, Wedemeyer H, et al. EASL clinical practice guidelines: management of hepatitis C virus infection. J Hepatol, 2011, 55(2): 245-264.

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Disability adjusted life years for liver cancer in China: trend analysis from 1990 to 2016 and future prediction

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