Abstract
ObjectiveThere is little information about contributions of the well-known risk factors to the liver cancer burden. We conducted a comparative study to estimate the liver cancer burden attributable to major risk factors.MethodsLiver 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. Population attributable fraction (PAF) by age, sex, and province was calculated using multiple formulas.ResultsIn total, 72.4% of liver cancer deaths could be attributable to the studied risk factors. Hepatitis B virus (HBV) was responsible for the largest fraction of liver cancer burden in both genders (PAF=55.6% in males, PAF=46.5% in females). PAFs for liver cancer burden attributable to smoking (15.7% vs. 4.8%), and alcohol drinking (10.3% vs. 1.6%) were significantly higher in males than in females. The burden of HBV-attributable deaths was the highest in Qinghai province. ConclusionsHBV 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 risk factors to liver cancer deaths.
Highlights
Liver cancer is the sixth most commonly diagnosed cancer and the third cancer-related death worldwide, with 905,677 cases and 830,180 deaths in 2020
hepatitis B virus (HBV) was responsible for 129,894 deaths in 2014 with a population attributable fraction (PAF) of 55.6%, while in females, the corresponding deaths were 39,660 with a PAF of 46.5%
17.4% and 15.9% of liver cancer deaths can be attributed to hepatitis C virus (HCV) in males and females, respectively
Summary
Liver cancer is the sixth most commonly diagnosed cancer and the third cancer-related death worldwide, with 905,677 cases and 830,180 deaths in 2020. Several epidemiological studies have identified several risk factors associated with liver cancer, including chronic infection with hepatitis B virus (HBV) or hepatitis C virus (HCV), alcohol consumption, tobacco use, metabolic diseases such as obesity and diabetes [2,3,4]. HBV and HCV, primary risk factors for liver cancer in China, have contributed to the most substantial proportion of liver cancer burden in China. The population attributable fraction (PAF) is an important epidemiologic metric, which could quantify the proportion that how many cancers could be avoided by eliminating a given risk factor [6]. PAF was defined as the amount of the cancer burden in the target population attributable to a risk factor.
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