S2882 Revealing New Trends in the Global Burden of Liver Cancer Related to Hepatitis C Virus

Introduction: Hepatocellular carcinoma (HCC) remains a leading cause of global cancer mortality, with a continually increasing incidence and poor 5-year survival. Hepatitis C virus (HCV) is a major risk factor for HCC, and while direct-acting antivirals (DAAs) have significantly reduced HCV-related HCC (HCV-HCC) risk, its global burden remains high. Given recent World Health Organization (WHO) initiatives to aimed at reducing hepatitis-related mortality, we evaluated trends in HCV-HCC from 1990 to 2021, stratified by gender, WHO region, and sociodemographic index (SDI), using data from the Global Burden of Disease 2021 study. Methods: We extracted data on deaths, disability-adjusted life years (DALYs), and age-standardized incidence (ASI) attributable to HCV. Trends were analyzed using Joinpoint regression to calculate annual percent change (APC) and average annual percent change (AAPC), with significance set at P < 0.05. Results: Globally, HCV-HCC deaths increased from 1990 to 2021 (woman AAPC 2.71 with 95% CI: 2.67–2.75 and man AAPC 2.65 with 95% CI: 2.60–2.70). Global DALYs also increased (woman AAPC 2.28 with 95% CI: 2.24–2.32 and man AAPC 2.16 with 95% CI: 2.10–2.21). In contrast, ASI declined (woman AAPC -0.51 with 95% CI: -0.53 to -0.51 and man AAPC -0.57 with 95% CI -0.61 to -0.53). In terms of WHO regions, DALYs rose across all WHO regions, with the Americas and Southeast Asia showing the highest increases. Deaths followed similar patterns, especially among men in the Americas and Eastern Mediterranean. ASI rates decreased in Africa, Western Pacific, and Eastern Mediterranean but rose in the Americas, Europe, and Southeast Asia. By SDI, middle and middle-low regions had the steepest increases in DALYs and deaths. High SDI regions saw the sharpest ASI declines after 2016, coinciding with WHO strategy implementation. ASI rates for women rose in high SDI settings and declined less than in men. Notably, ASI began to rise again after 2019 for both sexes. Conclusion: Despite treatment advances, absolute HCV-HCC burden has grown unevenly. The increase in HCV-HCC deaths and DALYs with overall decreased ASI could indicate a rising disease burden due to population aging and growth. Regions with better resources saw ASI reductions, while others lagged. Gender and SDI disparities highlight gaps in access to care, screening, and treatment. Tailored interventions, improved equity, and sustained global efforts are essential to achieve hepatitis elimination goals.