Global trends and regional differences of hepatoblastoma: a systematic analysis and predictions to 2035 based on the global burden of disease study 2021

肝母细胞瘤的全球趋势和区域差异:基于2021年全球疾病负担研究的系统分析及至2035年的预测

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Abstract

BACKGROUND: Hepatoblastoma accounts for the majority of liver malignancies in children with a high socioeconomic burden worldwide. Comprehensive and accurate burden data assessment is crucial for health policy planning. MATERIALS AND METHODS: Epidemiological data of hepatoblastoma was extracted from the Global Burden of Diseases Study 2021. The incidence, prevalence, mortality, and disability-adjusted life years (DALYs) were assessed and Joinpoint regression analysis was conducted to evaluate the time trends. Age-standardized rates (ASR) were used to compare the burden among different sociodemographic index (SDI) and GBD regions. The Bayesian age-period-cohort model was applied to predict the disease burden. RESULTS: In 2021, there were 4048.42 new cases (95% UI: 3252.45-5000.45) and 2416.17 deaths (95% UI: 1922.47-3019.03) worldwide, of which 35.0% of new cases and 40.9% of deaths occurred in low SDI countries, and the corresponding ASR of morbidity and mortality was 0.09 (95% UI: 0.06-0.12) and 0.06 (95% UI: 0.04-0.08). Western Sub-Saharan contributed the highest ASR of incidence (0.10) and death (0.07) across the 21 GBD regions. The morbidity (1.23) and mortality rate (0.74) of the under 1 year-old group were higher than those of other age groups. Compared with 1990, the incidence, mortality, and DALYs of hepatoblastoma decreased significantly, with estimated annual percentage change (EAPC) of -2.03, -2.54, and - 2.53. The high SDI regions exhibited an upward trend in incidence with EAPC of 0.73. Joinpoint regression analysis indicated a gradual but fluctuating decline in ASR of incidence, prevalence, death and DALYs. The global burden was predicted to decrease while an increased incidence and mortality in low SDI countries. CONCLUSION: The morbidity and mortality burden of hepatoblastoma has steadily decreased over the last 31 years. However, the increased incidence in high SDI areas and the higher mortality in low SDI areas pose a significant challenge. Effective differentiated intervention should be facilitated to reduce the impact of hepatoblastoma.

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