{
  "abstract": "Background Liver cancer (LC) is among the most lethal and economically burdensome malignancies, driven increasingly by metabolic dysfunction (NASH), alcohol use, and residual viral hepatitis in high-income regions. Despite accounting for a disproportionate share of cancer deaths and DALYs relative to its incidence and prevalence, comprehensive assessments of long-term LC trends across high-income settings remain limited.Methods We analyzed the LC burden in high-income countries using Global Burden of Disease (GBD) 1990–2023 data. Outcomes included incidence, prevalence, deaths, and DALYs, with age-standardized trends quantified using regression-based estimated annual percentage change (EAPC). Subtype-specific trends (NASH, alcohol-related, HBV, HCV, other causes, hepatoblastoma) and regional and sex-stratified patterns were also evaluated.Results In 2023, LC accounted for 4.24% of all deaths, 0.41% of all incident cancers, 4.19% of total DALYs, and 0.36% of total prevalence in high-income regions. From 1990–2023, the fastest rise in LC burden was observed in Southern-Latin-America(incidence, DALYs,deaths:+2.8%,+3.1%,+2.6%), followed by Australasia(2.3%, 2.7%,2.4%) and Western-Europe(1.9%,2.1%,1.8%), while increases were more modest in High-income-Asia-Pacific(0.7%,0.9%,0.6%) and High-income-North America (0.4%,0.6%,0.5%). Across LC subtypes, NASH exhibited the greatest growth in incidence, prevalence, and deaths(3.42%,3.58%,3.22%), followed by alcohol-related (3.10%,3.23%,3.00%), other causes (2.74%,2.82%,2.59%), HCV (2.32%, 2.36%, 2.31%), HBV (1.67%, 1.72%, 1.58%), and hepatoblastoma, which showed comparatively mild change (0.55%, 1.60%, –1.34%). Overall APC in age-standardized DALY rates ranged from −2.6% (Japan) to 3.4% (Cyprus), with the steepest increases again seen for NASH-related LC (1.8% to 4.1%/year) and alcohol-related LC (0.6% to 3.2%), whereas HBV/HCV-related LC declined modestly (−0.8% to −1.4%). By sex, men consistently exhibited higher LC burden than women, with male vs female EAPC 1.31% vs 1.81% for mortality. The EAPC analysis showed that liver cancer incidence and mortality increased among adults aged 55+ (0.71% and 0.47%), whereas younger groups (<20 and 20–54 years) experienced declines in DALYs (–1.08% and –0.87%) and deaths (–1.13% and –0.80%). ( IDDF2026-ABS-0534 Figure 1. Liver cancer subtype age-standardized DALYs rate EAPC in high-income countries from 1990-2023, IDDF2026-ABS-0534 Figure 2. Age-wise Burden of Lung Cancer and its Subtype in High Income Countries from 1990-2023)Conclusions LC burden continues to rise across high-income regions, driven predominantly by accelerating metabolic (NASH) and alcohol-related subtypes, with notable regional heterogeneity and consistently higher increases among women. These patterns highlight an urgent need for region-specific prevention strategies targeting metabolic dysfunction, obesity, alcohol misuse, and persistent viral hepatitis to curb the growing LC burden and reduce widening disparities.Abstract IDDF2026-ABS-0534 Figure 1Abstract IDDF2026-ABS-0534 Figure 2",
  "authors": [
    {
      "affiliations": [
        "AB Plus Multispecialty Hospital, Ahmedabad, Gujarat, India"
      ],
      "name": "Hardik Dineshbhai Desai"
    },
    {
      "affiliations": [
        "MercyOne Medical Center Internal Medicine Program, Des Moines, Iowa, United States"
      ],
      "name": "Shabarnadh Gangi Reddy"
    },
    {
      "affiliations": [
        "Narayana Medical College, Nellore, India"
      ],
      "name": "Harshitha Thogata"
    },
    {
      "affiliations": [
        "Verde Valley Medical Center, Cottonwood, AZ, United States"
      ],
      "name": "Mansha Gupt"
    },
    {
      "affiliations": [
        "Apollo Institute of Medical Sciences and Research, Chittoor, Andhra Pradesh, India"
      ],
      "name": "Yojan Chandra Reddy Vennapusa"
    },
    {
      "affiliations": [
        "Northwest Health - Radiation Oncology, Valparaiso, IN, United States"
      ],
      "name": "Fnu Bhuvan"
    },
    {
      "affiliations": [
        "UCF/HCA Florida Ocala hospital, United States"
      ],
      "name": "Sai Varun Gadde"
    },
    {
      "affiliations": [
        "AB Plus Multispecialty Hospital, Ahmedabad, Gujarat, India"
      ],
      "name": "Parth Sudhendu Patel"
    }
  ],
  "title": "IDDF2026-ABS-0534 Regional heterogeneity in liver cancer trends across high-income countries, 1990-2023: the emerging dominance of metabolic and alcohol-related disease",
  "uid": "4ed251da-9892-5ddd-9928-554fb78abf32"
}