P74 Global trends in primary liver cancer between since 2000

Introduction Primary liver cancer (PLC) encompasses hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (iCCA). The global burden of PLC is thought to be increasing in the 21st century, characterized by high lethality and significant absolute increases in new cases and deaths between 2000 and 2023. This study characterises the global trends in PLC incidence and mortality, identifies key aetiological shifts, and highlights urgent public health priorities. Methods Incidence, mortality, and aetiology data for PLC between 2000 and 2023 were collected for countries/territories from the Global Burden of Diseaes Study 2023. Global and country-specific agestandardised incidence (ASIR) and mortality (ASMR) rates were determined across the study period. Underlying liver disease aetiology data relating to PLC, including alcohol-related liver disease (ArLD), hepatitis B (HBV), hepatitis C (HCV) and metabolic-dysfunction associated steatotic liver disease (MASLD) global region. Average annual percentage change (AAPC) outlined trends in incidence and mortality. Results The overall global burden of PLC has been increasing, with the absolute number of new cases and deaths increasing significantly (59.4% and 55.8%, respectively) between 2000 and 2023. Although agestandardised incidence and mortality rates declined since 2000, there has been a reversal in this decline since 2020. In particular, HBV- and HCV-associated rates, after historical declines, showed a concerning rebound starting circa 2020. Viral hepatitis (HBV and HCV) remained the dominant cause globally, but its proportion is decreasing with MASLD showed the greatest average annual increase in new cases. There is global variation in PLC-related liver disease aetiology, with HBV predominant in East Asia and sub-Saharan Africa, HCV in the Middle East, North Africa, Northern America, and Latin America, and ArLD in Europe and Australasia. MASLD rates showed a consistent rise across all regions. Conclusions The global burden of primary liver cancer continues to rise, with a concerning reversal of historical declines in incidence and mortality since 2020. An increase in viral hepatitis related PLC during this time and the consistent rise of MASLD rates across the 21st century underscores an urgent need for sustained public health intervention and clinical action.