Epidemiological trends and risk attribution of early-onset liver cancer: insights from the Global Burden of Disease study 2021

BACKGROUND: Early-onset liver cancer is emerging as a critical global health challenge. This study aimed to evaluate the burden of early-onset liver cancer from various perspectives, as well as the contributions of associated risk factors. METHODS: We utilized data associated with early-onset liver cancer from the Global Burden of Disease study 2021 to assess the incidence and disability-adjusted life year (DALYs) burden. The estimated annual percentage change (EAPC) was also calculated to evaluate temporal trends. RESULTS: On a global scale, the disease burden of early-onset liver cancer decreased significantly, whereas only early-onset liver cancer due to nonalcoholic steatohepatitis (NASH) showed an increasing incidence burden. Males had a substantially higher early-onset liver cancer burden compared to females. Regionally, Australasia exhibited the most rapid growth in the age-standardized incidence rate of early-onset liver cancer (EAPC = 3.09). By countries, the highest age-standardized incidence rate was observed in Mongolia (12.93 per 100,000). According to sociodemographic index (SDI), early-onset liver cancer burden demonstrated a significant negative association with SDI. Among risk factors, alcohol use played a leading role in the DALYs, and high body-mass index showed the largest increase over the past 32 years. Additionally, high-income North America accounted for the highest attributable proportions of high body-mass index in 2021. CONCLUSION: Less developed countries bear a heavy burden of early-onset liver cancer, necessitating more effective interventions. Meanwhile, the escalating NASH-related early-onset liver cancer burden highlights the preventive potential of weight control, especially in high-income regions where a high body-mass index predominates.