The spatiotemporal dynamics and disease burden of liver cancer among the elderly in Yunnan of China, 2012-2020

Abstract

Background

The burgeoning incidence and mortality rates of tumors, exacerbated by an aging population, pose a significant public health challenge in China. While global and domestic trends from 2018 to 2022 indicate a stabilization or decline in liver cancer rates, the spatiotemporal dynamics and disease burden among the elderly in Yunnan, China, remain insufficiently characterized.

Methods

This study encompasses a retrospective analysis of 26,328 liver cancer patients aged 60 and above, drawn from the household population of Yunnan, China, between 2012 and 2020. The evaluation adheres to the China Cancer Registry Guidance Manual (2016) and aligns with data standards set by the International Agency for Research on Cancer (IARC) and the International Association of Cancer Registries (I-ACR). The Joinpoint software was utilized to ascertain the annual percentage change (APC) in liver cancer incidence and mortality from 2012 to 2020.

Findings

Between 2012 and 2020, the incidence rate of liver cancer among the elderly in Yunnan, China, stood at 71.76 per 100,000 (CSR of 70.87 per 100,000 and WSR of 69.55 per 100,000), with a male incidence rate of 99.39 per 100,000 (CSR 99.10 per 100,000 and WSR 97.78 per 100,000) and a female rate of 45.91 per 100,000 (CSR 43.95 per 100,000 and WSR 42.54 per 100,000). The mortality rate for liver cancer in this demographic was 70.12 per 100,000 (CSR 68.43 per 100,000 and WSR 66.73 per 100,000), with males at 96.65 per 100,000 (CSR 95.61 per 100,000 and WSR 93.69 per 100,000) and females at 45.31 per 100,000 (CSR 42.63 per 100,000 and WSR 41.05 per 100,000). Liver cancer incidence among elderly males in Yunnan Province ranked third among all malignant tumors in 2012 and maintained this ranking in 2020. For elderly females, liver cancer rose from the fourth to the third position, marking an increase of one rank. Mortality rankings placed liver cancer second among males and third among females, with no change observed. Over the 2012-2020 period, the incidence rate of liver cancer in Yunnan's elderly exhibited an overall upward trajectory (APC 95% CI: 0.37%-3.8%), with male and female trends remaining stable (males: APC 95% CI: -0.35%-5.83%; females: APC 95% CI: -3.67%-7.26%). The overall mortality trend for liver cancer in the elderly was upward (APC 95% CI: 1.35% to 4.12%), with males showing an increasing trend (APC 95% CI: 0.74% to 4.51%) and females maintaining a stable rate (APC 95% CI: -0.85% to 8.0%).

Interpretation

The incidence of malignant tumors correlates with the Human Development Index (HDI), with liver cancer prevalent in regions of lower HDI. While the incidence rate of liver cancer among the elderly in China has been on a downward trajectory in recent years, mirroring trends in Asia, Yunnan's elderly population defies this pattern with increasing incidence and mortality rates. This divergence from the national trend underscores the need for a focused, precision public health approach to liver cancer prevention and control, particularly among the elderly population in this underdeveloped region.