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Long-Term Trends of Liver Cancer Incidence and Mortality in China 1990–2017: A Joinpoint and Age–Period–Cohort Analysis

1
Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan 430071, China
2
School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
3
Medical College of Hubei University of Arts and Science, Xiangyang 441053, China
4
Global Health Institute, Wuhan University, Wuhan 430072, China
*
Authors to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2019, 16(16), 2878; https://doi.org/10.3390/ijerph16162878
Received: 5 July 2019 / Revised: 31 July 2019 / Accepted: 9 August 2019 / Published: 12 August 2019
(This article belongs to the Collection Health Behaviors, Risk Factors, NCDs and Health Promotion)
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Abstract

Liver cancer (LC) is one of the most common causes of cancer-related deaths: this study aims to present the long-term trends and age–period–cohort effects of the incidence of and mortality from LC in China during 1990–2017. Incidence and mortality data were obtained from the Global Burden of Disease Study 2017. We determined trends in the age-standardized incidence rate (ASIR) and mortality rate (ASMR) using Joinpoint regression. An age–period–cohort (APC) analysis was performed to describe the long-term trends with intrinsic estimator methods. The ASMR decreased markedly before 2013 and increased thereafter, with overall average annual percent change (AAPC) values of −0.5% (95% confidence interval (CI): −0.6%, −0.3%) for men and −1.3% (−1.6%, −1.0%) for women during 1990–2017. The ASIR significantly increased by 0.2% (0.1%, 0.3%) in men and decreased by 1.1% (−1.2%, −1.0%) in women from 1990 to 2017. The risks of LC incidence and mortality increased with age in both genders. The period effect risk ratios (RRs) of incidence and mortality displayed similar monotonic increasing trends in men and remained stable in women. The cohort effect showed an overall downward trend and almost overlapping incidence and mortality in both genders, and later birth cohorts experienced lower RRs than previous birth cohorts. Older age, recent period, and birth before 1923 were associated with a higher risk of liver cancer incidence and mortality. The net age and period effects showed an increasing trend, while the cohort effects presented a decreasing trend in incidence and mortality risk. As China’s population aging worsens and with the popularization of unhealthy lifestyles, the burden caused by liver cancer will remain a huge challenge in China’s future. View Full-Text
Keywords: liver cancer; incidence; mortality; Joinpoint regression analysis; age–period–cohort model; trends liver cancer; incidence; mortality; Joinpoint regression analysis; age–period–cohort model; trends
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Wang, F.; Mubarik, S.; Zhang, Y.; Wang, L.; Wang, Y.; Yu, C.; Li, H. Long-Term Trends of Liver Cancer Incidence and Mortality in China 1990–2017: A Joinpoint and Age–Period–Cohort Analysis. Int. J. Environ. Res. Public Health 2019, 16, 2878.

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