{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T10:47:57Z","timestamp":1790938077738,"version":"4.1.0"},"reference-count":28,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,2,27]],"date-time":"2025-02-27T00:00:00Z","timestamp":1740614400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Studies have shown a change in the etiological profile of liver cancer globally. We aimed to analyze the burden and changes in etiology of liver cancer in the Asia\u2010Oceania region.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The burden of liver cancer in Asia\u2010Oceania was estimated using data from the 2021 Global Burden of Disease (GBD) Study. The analysis included age\u2010standardized incidence (ASIR), prevalence (ASPR), mortality (ASMR), and disability\u2010adjusted life years (DALY) per 100\u2009000 population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The Asia\u2010Oceania region contributed 68.6%, 68.8%, and 67.3% of the global incidence, prevalence, and mortality of liver cancer in 2021. In 2021, Mongolia, Tonga, and South Korea had the highest ASIR, ASPR, and ASMR, whereas Australia, New Zealand, and Guam had the greatest increase in incidence and mortality rates. Viral hepatitis remained the most common etiology of liver cancer, with 47.7% and 26.1% of cases being related to hepatitis B virus (HBV) and hepatitis C virus (HCV), respectively. Around 14.5% and 7.1% of cases were related to alcohol and nonalcoholic steatohepatitis (NASH), respectively; however, the annual change in the ASIR was the highest for NASH. Alcohol, drug abuse, tobacco use, and metabolic syndrome, contributed to 15.2%, 11.7%, 11.5%, and 9.0% of liver cancer mortality in 2021; however, the change in death from 1990 to 2021 was the highest for metabolic syndrome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Viral hepatitis remains the most common cause of liver cancer, with NASH having the highest annual rate of change in ASIR and liver cancer deaths in Asia\u2010Oceania.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jgh.16922","type":"journal-article","created":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T20:57:47Z","timestamp":1741726667000},"page":"1188-1201","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Metabolic Cause of Cirrhosis Is the Emerging Etiology for Primary Liver Cancer in the Asia\u2010Oceania Region: Analysis of Global Burden of Disease (GBD) Study 2021"],"prefix":"10.1111","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9626-5243","authenticated-orcid":false,"given":"Suprabhat","family":"Giri","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology Kalinga Institute of Medical Sciences  Bhubaneswar India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sushrut","family":"Ingawale","sequence":"additional","affiliation":[{"name":"Division of Internal Medicine Frank H. Netter MD School of Medicine  Bridgeport Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2605-3675","authenticated-orcid":false,"given":"Gaurav","family":"Khatana","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Government Medical College  Kottayam India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prasanna","family":"Gore","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Wellness Hospital  Hyderabad India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4995-1611","authenticated-orcid":false,"given":"Dibya\u00a0Lochan","family":"Praharaj","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Kalinga Institute of Medical Sciences  Bhubaneswar India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2215-9410","authenticated-orcid":false,"given":"Vincent\u00a0Wai\u2010Sun","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Medicine and Therapeutics The Chinese University of Hong Kong  Hong Kong China"},{"name":"State Key Laboratory of Digestive Disease and Department of Surgery The Chinese University of Hong Kong  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel\u00a0Q.","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Medicine, Yong Loo Lin School of Medicine National University of Singapore  Singapore Singapore"},{"name":"Division of Gastroenterology and Hepatology, Department of Medicine National University Health System  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit","family":"Singhal","sequence":"additional","affiliation":[{"name":"Division of Digestive and Liver Diseases UT Southwestern Medical Center  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6540-2623","authenticated-orcid":false,"given":"Ashok","family":"Choudhury","sequence":"additional","affiliation":[{"name":"Department of Hepatology Institute of Liver and Biliary Sciences  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,2,27]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21834"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2020.02.068"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jceh.2024.101447"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.31280"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1159\/000333210"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2018.05.057"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhepr.2021.100231"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jceh.2024.101391"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.17998\/jlc.2024.03.13"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)00757-8"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCG.0b013e3182872f29"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21492"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.32723"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11427-016-9043-9"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.4530"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cld.2016.06.006"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1053\/jhep.2001.27831"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)32111-1"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.28431"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2021.05.022"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-018-5331-x"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.7869\/tg.120"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.4254\/wjh.v11.i1.1"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2020.01.043"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jceh.2023.10.002"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41575-023-00759-2"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2023.11.006"},{"key":"e_1_2_8_29_1","first-page":"3265","article-title":"Can We Rely on GLOBOCAN and GBD Cancer Estimates? 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