{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T21:58:23Z","timestamp":1777931903314,"version":"3.51.4"},"reference-count":63,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Youth Fund Project of Humanities and Social Sciences Research of Ministry of Education in 2024","award":["24YJCZH448"],"award-info":[{"award-number":["24YJCZH448"]}]},{"name":"The Second Batch of Provincial-Level Teaching Reform Project for Postgraduates in Zhejiang Province","award":["JGCG2024254"],"award-info":[{"award-number":["JGCG2024254"]}]},{"name":"Traditional Chinese Medicine Science and Technology Plan of Zhejiang Province","award":["2026ZF42"],"award-info":[{"award-number":["2026ZF42"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Cancer Control"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Liver cancer (LivCa) is one of the most prevalent malignancies globally, and can result from viral hepatitis, non-alcoholic steatohepatitis (NASH), and alcohol use. LivCa is of increasing concern in Asia, but the burden of etiology-specific LivCa and future projections remain to be elucidated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We extracted the incidence, mortality, and disability-adjusted life years (DALYs) of LivCa across Asia and in 34 Asian countries in 1990-2021 from the Global Burden of Disease Study 2021 (GBD 2021). We then calculated their estimated annual percentage change (EAPC) and percentage variation to quantify the changes in the burden of LivCa. The association of the level of social development with LivCa burden was explored using the sociodemographic index (SDI). Moreover, the trend of the epidemiology of LivCa burden in Asia from 2022 to 2040 was predicted using the Bayesian age-period-cohort (BAPC) model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, the age-standardized incidence, mortality, and DALYs rates of LivCa in Asia showed a general declining trend, with EAPCs of -0.47, -0.73, and -1.14, respectively. Notably, hepatitis B virus remained the predominant cause. However, the burdens attributed to non-alcoholic steatohepatitis and alcohol use increased significantly, while that of hepatoblastoma decreased. Regarding demographic distribution, the highest disease burden was observed among males and the elderly population aged 85\u201394 years. Geographically, Nepal, Taiwan (Province of China), India, and Malaysia contributed most substantially to the increasing burden. In terms of risk factors, high BMI and alcohol use were prominent in Central Asia, whereas smoking was a key factor in East and Southeast Asia. Additionally, a positive correlation was observed between the SDI and the burden of LivCa. Finally, projections from the BAPC model indicated a persistent decline in the burden of LivCa from 2022 to 2040.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Despite the overall decreasing trend, targeted strategies addressing etiology-specific risks and regional disparities are urgently needed to further reduce the future burden of LivCa in Asia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10732748261446367","type":"journal-article","created":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T20:30:38Z","timestamp":1777321838000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Asian Burden of Liver Cancer 1990-2021 and Predictions to 2040: An Analysis of the Global Burden of Disease Study 2021"],"prefix":"10.1177","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-2849-8732","authenticated-orcid":false,"given":"Liandong","family":"Chen","sequence":"first","affiliation":[{"name":"Zhejiang Chinese Medical University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weibo","family":"Zheng","sequence":"additional","affiliation":[{"name":"Zhejiang Chinese Medical University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haojie","family":"Ying","sequence":"additional","affiliation":[{"name":"Zhejiang Chinese Medical University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xinyue","family":"Chen","sequence":"additional","affiliation":[{"name":"Zhejiang Chinese Medical University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Han","family":"Yan","sequence":"additional","affiliation":[{"name":"Zhejiang Chinese Medical University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Binzhe","family":"Zhou","sequence":"additional","affiliation":[{"name":"Zhejiang Chinese Medical University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuyuan","family":"Sun","sequence":"additional","affiliation":[{"name":"Zhejiang Chinese Medical University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qihui","family":"Shao","sequence":"additional","affiliation":[{"name":"Zhejiang Chinese Medical University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hanyu","family":"Xu","sequence":"additional","affiliation":[{"name":"Zhejiang Chinese Medical University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bowen","family":"Jin","sequence":"additional","affiliation":[{"name":"Zhejiang Chinese Medical University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haonan","family":"Jin","sequence":"additional","affiliation":[{"name":"Zhejiang Chinese Medical University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bin","family":"Fu","sequence":"additional","affiliation":[{"name":"Zhejiang Chinese Medical University"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,4,27]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2022.11.015"},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.3390\/curroncol30010016"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/hep.26231"},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660"},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/10732748241297346"},{"key":"e_1_3_6_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/his.13975"},{"key":"e_1_3_6_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hbpd.2020.07.004"},{"key":"e_1_3_6_9_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-018-0019-2"},{"issue":"4","key":"e_1_3_6_10_2","first-page":"417","article-title":"Aflatoxins: current concepts on mechanisms of toxicity and their involvement in the etiology of hepatocellular carcinoma","volume":"31","author":"de Oliveira CA","year":"1997","unstructured":"de Oliveira CA, Germano PM. Aflatoxins: current concepts on mechanisms of toxicity and their involvement in the etiology of hepatocellular carcinoma. Rev Saude Publica. 1997;31(4):417-424.","journal-title":"Rev Saude Publica"},{"key":"e_1_3_6_11_2","doi-asserted-by":"publisher","DOI":"10.1155\/2017\/5202684"},{"key":"e_1_3_6_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(23)00197-8"},{"key":"e_1_3_6_13_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0163423"},{"key":"e_1_3_6_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2024.102765"},{"key":"e_1_3_6_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2022.08.021"},{"key":"e_1_3_6_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00432-024-05855-7"},{"key":"e_1_3_6_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jceh.2014.02.155"},{"key":"e_1_3_6_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.metabol.2021.154866"},{"key":"e_1_3_6_19_2","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.29227"},{"key":"e_1_3_6_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00436-016-5276-y"},{"key":"e_1_3_6_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2017.06.003"},{"key":"e_1_3_6_22_2","doi-asserted-by":"publisher","DOI":"10.3350\/cmh.2022.0316"},{"key":"e_1_3_6_23_2","doi-asserted-by":"publisher","DOI":"10.5009\/gnl17102"},{"key":"e_1_3_6_24_2","doi-asserted-by":"publisher","DOI":"10.1111\/liv.15251"},{"key":"e_1_3_6_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)00757-8"},{"issue":"10440","key":"e_1_3_6_26_2","first-page":"1988","article-title":"Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990\u20132021: a systematic analysis for the Global Burden of Disease Study 2021","volume":"403","author":"GBD 2021 Causes of Death Collaborators","year":"2024","unstructured":"GBD 2021 Causes of Death Collaborators. Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990\u20132021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet. 2024;403(10440):1988.","journal-title":"Lancet"},{"key":"e_1_3_6_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30752-2"},{"key":"e_1_3_6_28_2","doi-asserted-by":"publisher","DOI":"10.1186\/s10194-024-01798-z"},{"key":"e_1_3_6_29_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2022.1622"},{"key":"e_1_3_6_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ecoenv.2022.113588"},{"key":"e_1_3_6_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2023.04.060"},{"key":"e_1_3_6_32_2","doi-asserted-by":"publisher","DOI":"10.1080\/07853890.2024.2328521"},{"key":"e_1_3_6_33_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2017.3055"},{"key":"e_1_3_6_34_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-023-02040-4"},{"key":"e_1_3_6_35_2","doi-asserted-by":"publisher","DOI":"10.1097\/CM9.0000000000003442"},{"key":"e_1_3_6_36_2","doi-asserted-by":"publisher","DOI":"10.1097\/MEG.0000000000002899"},{"issue":"8","key":"e_1_3_6_37_2","first-page":"679","article-title":"Attributable liver cancer deaths and disability-adjusted life years in China and worldwide: profiles and changing trends","volume":"21","author":"Cao M","year":"2024","unstructured":"Cao M, Xia C, Cao M, et al. Attributable liver cancer deaths and disability-adjusted life years in China and worldwide: profiles and changing trends. Cancer Biol Med. 2024;21(8):679-691.","journal-title":"Cancer Biol Med"},{"key":"e_1_3_6_38_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(23)00149-4"},{"key":"e_1_3_6_39_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.canlet.2022.215652"},{"key":"e_1_3_6_40_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12072-015-9629-x"},{"key":"e_1_3_6_41_2","doi-asserted-by":"publisher","DOI":"10.46234\/ccdcw2020.151"},{"key":"e_1_3_6_42_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2542-5196(24)00285-7"},{"key":"e_1_3_6_43_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1368980019002167"},{"key":"e_1_3_6_44_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1753-4887.2001.tb06967.x"},{"key":"e_1_3_6_45_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2025.1527328"},{"key":"e_1_3_6_46_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12072-025-10782-x"},{"key":"e_1_3_6_47_2","doi-asserted-by":"publisher","DOI":"10.3389\/fnut.2025.1510563"},{"key":"e_1_3_6_48_2","doi-asserted-by":"publisher","DOI":"10.3390\/cancers17040609"},{"key":"e_1_3_6_49_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12072-024-10750-x"},{"key":"e_1_3_6_50_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph15010170"},{"key":"e_1_3_6_51_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10552-010-9570-1"},{"key":"e_1_3_6_52_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2026.113081"},{"key":"e_1_3_6_53_2","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2025.1630875"},{"key":"e_1_3_6_54_2","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000003288"},{"issue":"6","key":"e_1_3_6_55_2","first-page":"679","article-title":"Lancet Commission 2025 Calls for Urgent Global Action: 60% of Liver Cancers Are Preventable","volume":"14","author":"Kudo M","year":"2025","unstructured":"Kudo M. Lancet Commission 2025 Calls for Urgent Global Action: 60% of Liver Cancers Are Preventable. Liver Cancer. 2025;14(6):679-686.","journal-title":"Liver Cancer"},{"key":"e_1_3_6_56_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(24)00369-7"},{"key":"e_1_3_6_57_2","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2025.1632476"},{"key":"e_1_3_6_58_2","doi-asserted-by":"publisher","DOI":"10.17998\/jlc.2025.07.25"},{"key":"e_1_3_6_59_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccell.2023.05.010"},{"key":"e_1_3_6_60_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2022.956712"},{"key":"e_1_3_6_61_2","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v28.i21.2361"},{"key":"e_1_3_6_62_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jes.2022.05.037"},{"key":"e_1_3_6_63_2","doi-asserted-by":"publisher","DOI":"10.1007\/s44197-023-00109-0"},{"key":"e_1_3_6_64_2","article-title":"Global, regional, and national burden of hepatocellular carcinoma and contribution of nine modifiable risk factors across 185 countries\/territories in 2022","author":"Li P","year":"2025","unstructured":"Li P, Ding Z, Feng Y, Ren X, Wei Y, Xia C, et al. Global, regional, and national burden of hepatocellular carcinoma and contribution of nine modifiable risk factors across 185 countries\/territories in 2022. Sci Bull (Beijing). 2025;71.","journal-title":"Sci Bull (Beijing)"}],"container-title":["Cancer Control"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10732748261446367","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10732748261446367","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10732748261446367","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T01:01:05Z","timestamp":1777683665000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10732748261446367"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":63,"alternative-id":["10.1177\/10732748261446367"],"URL":"https:\/\/doi.org\/10.1177\/10732748261446367","relation":{},"ISSN":["1073-2748","1526-2359"],"issn-type":[{"value":"1073-2748","type":"print"},{"value":"1526-2359","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4]]},"article-number":"10732748261446367"}}