Geographical disparities in hepatitis b virus related hepatocellular carcinoma mortality rates worldwide from 1990 to 2019

Abstract

This study aims to evaluate global trends in hepatitis B virus-related hepatocellular carcinoma (HBV-HCC) related mortality over the past 30 years. Despite improvements in the treatment of both HBV and HCC, disparities in access to care and treatment persist, and these disparities may have affected HBV-HCC outcomes across certain global regions disproportionately. Using data from the Global Burden of Diseases, Injury, and Risk Factors Study (GBD) from 1990 to 2019, we evaluated overall mortality rates related to HBV-HCC. From 1990 to 2019, overall global HBV-HCC mortality rate decreased by 30.3%. While most world regions experienced declines in HBV-HCC mortality, several regions also experienced significant increases in mortality, including Australasia, Central Asia, and Eastern Europe. When stratified by age, all age groups demonstrated declines in HBV-HCC mortality from 1990 to 2019. Similar trends were observed for both men and women. When stratified by world regions, HBV-HCC mortality in 2019 was highest in East Asia, which was significantly higher than the region with the next highest HBV-HCC mortality, Southeast Asia. Significant disparities in HBV-HCC mortality are observed among global regions. We observed higher HBV-HCC mortality rates with older age, higher mortality in males, and highest mortality in East Asia. The clinical significance of these findings are to highlight those regions that need more targeted resources to improve HBV testing and treatment to reduce the long term consequences of untreated HBV, such as HCC.