Burden of liver cancer in adolescents and young adults aged 15-49 years in China: a comprehensive analysis based on the Global Burden of Disease study (1990-2021)

Aim: Globally, primary liver cancer ranks as the third most common cause of mortality among cancer patients. China reports the highest number of cases in the world, with chronic hepatitis B virus (HBV) infection being the most common cause. Recent studies have shown an increasing risk among adolescents and young adults aged 15-49 years, posing a significant public health challenge. Methods: This study uses the latest data from the Global Burden of Disease (GBD) 2021 to systematically evaluate the disease burden of liver cancer among individuals aged 15-49 years in China from 1990 to 2021. Results: The results show an increase in liver cancer cases and deaths in this age group, with a decreasing trend in incidence and mortality rates. The highest incidence and mortality rates were observed in the 45-49-year age group, with a significant increase in disease burden in men and a decrease in women. The annual net decreases in incidence and mortality rates are 1.65% and 2.31%, respectively. In the Chinese adolescent population aged 15-49 years, more than 80% of liver cancer cases are attributable to HBV. Other major risk factors include hepatitis C virus (HCV), alcohol consumption, non-alcoholic steatohepatitis (NASH), smoking, high body mass index (BMI), and high fasting plasma glucose. Conclusion: Our study underscores the potential of HBV vaccination and lifestyle interventions in controlling Chinese adolescents’ liver cancer incidence, and provides valuable insights for other countries and regions facing similar stages of development and major health challenges related to liver cancer.