Abstract: Background As one of the diseases with a heavy burden in China, liver cancer's lifetime risk indicators provide a more intuitive measure for public health, and analysing and predicting its current epidemiology can offer new insights for formulating disease prevention and control decisions. Objective This study mainly compares and analyses the lifetime risk of developing and dying from liver cancer in China, East Asia, and globally from 1990 to 2023, and predicts the trend of changes in the lifetime risks of liver cancer in China and globally from 2024 to 2035. Methods Data from GBD 2023 were used to extract lifetime risks of liver cancer in China, East Asia, and globally from 1990 to 2023. Using the 'Multiple Primary-cancer Correction (AMP)' method to calculate the lifetime incidence risk and lifetime mortality risk indicators for liver cancer in China, East Asia, and globally from 1990 to 2023 . Use Joinpoint to calculate the average annual percentage change (AAPC) from 1990 to 2023 and the corresponding 95% confidence interval (CI).A comprehensive analysis and description of the differences in lifetime risks of liver cancer in 2023 in China, East Asia, and globally, by age interval and sex. The autoregressive integrated moving average (ARIMA) model was used to predict the changing trends in lifetime risks of liver cancer in China and globally from 2024 to 2035. Results From 1990 to 2023, the LRI and LRM of liver cancer in China, East Asia and globally have all been on the rise (AAPC were 3.121%, 3.215%, 3.497% and 2.700%, 2.737%, 3.164% respectively). Among them, male LRI and LRM (AAPC were 3.709%, 3.365%, 3.961% and 2.877%, 2.891%, 3.679%) were higher than females (AAPC were 1.808%, 1.941%, 2.746% and 1.448%, 1.536%, 2.427%), and the difference was statistically significant (P<0.05). In 2023, the LRI and LRM for different types of liver cancer in China were higher in men than in women, with the highest LRI and LRM caused by HBV infection, with AAPCs of 2.618% and 2.228% respectively; followed by HCV infection, with AAPCs of 0.854% and 0.610% respectively. In 2023, the LRI and LRM of liver cancer for males from birth to death (0 years and older) in China, East Asia, and globally were 0.212%, 0.211%, 0.205% and 0.172%, 0.171%, 0.177%, all decreasing with age; for females, the LRI and LRM of liver cancer from birth to death (0 years and older) showed no obvious trend (0.064%, 0.065%, 0.065% and 0.053%, 0.054%, 0.057%, respectively). The ARIMA model prediction shows that by 2035, the global overall LRI and LRM for liver cancer are expected to continue increasing, reaching 0.160% and 0.137% respectively; for men, it's 0.259% and 0.222%, and for women, 0.079% and 0.069%. In China, the overall LRI and LRM for liver cancer are 0.148% and 0.120%, with men at 0.226% and 0.182% and women at 0.068% and 0.057%.Conclusion The lifetime risk of developing and dying from liver cancer in China remains high, especially among men, and is even higher than the global level. It reminds us that we should strengthen comprehensive prevention and control efforts to intervene in liver cancer related risk factors, promote liver cancer education, continuously enhance the level and measures of screening and early diagnosis and treatment, thereby reducing the burden of liver cancer.

Key words: Liver cancer, Lifetime risk of disease, Lifetime risk of death

摘要： 背景 肝癌作为中国疾病负担较重的疾病之一，其终生风险指标为公共卫生提供了更直观的衡量标准，分析和预测其流行现状能够为制定疾病预防和控制决策提供新的见解。目的 分析1990—2023年中国、东亚和全球肝癌终生发病风险与终生死亡风险情况，并对2024—2035年中国和全球肝癌终生风险变化趋势进行预测，为精准防控提出参考。方法 提取全球疾病负担(GBD)2023数据库中的开放数据，采用“多重原发癌校正（AMP）”方法计算1990—2023年中国、东亚和全球肝癌的终生发病风险（LRI）与终生死亡风险（LRM）。采用Joinpoint计算1990—2023年平均年度变化百分比(AAPC)。从性别和年龄两个维度对2023年中国、东亚和全球不同肝癌类型LRI和LRM差异进行对比分析。采用整合移动平均自回归(ARIMA)模型预测2024—2035年中国及全球肝癌LRI和LRM变化趋势。结果 1990—2023年中国、东亚和全球肝癌的LRI及LRM均呈上升趋势（AAPC分别为3.121%、3.215%、3.497%和2.700%、2.737%、3.164%），其中，男性LRI和LRM（AAPC分别为3.709%、3.365%、3.961%和2.877%、2.891%、3.679%）均高于女性（AAPC分别为1.808%、1.941%、2.746%和1.448%、1.536%、2.427%），差异有统计学意义（P<0.05）。2023年中国不同肝癌类型的LRI和LRM均呈现男性高于女性的特点，其中，HBV感染所致的LRI和LRM最高，AAPC分别为2.618%和2.228%；其次是HCV感染，AAPC分别为0.854%和0.610%。2023年中国、东亚和全球男性从出生到死亡（0岁及以上）肝癌的LRI和LRM分别为0.212%、0.211%，0.205%和0.172%、0.171%、0.177%，均随着年龄的增长而降低；女性从出生到死亡（0岁及以上）肝癌的LRI和LRM变化趋势不明显（分别为0.064%、0.065%，0.065%和0.053%、0.054%、0.057%）。ARIMA模型预测结果显示，到2035年，预计全球肝癌整体LRI和LRM仍呈增长趋势，分别为0.160%和0.137%；其中，男性为0.259%和0.222%，女性为0.079%和0.069%；中国肝癌整体LRI和LRM分别为0.148%和0.120%，其中男性为0.226%和0.182%，女性为0.068%和0.057%。结论 中国肝癌终生发病风险和终生死亡风险均呈逐年上升趋势，尤其男性人群，高于全球，提示我们应加大综合防控力度干预肝癌相关危险因素，普及开展肝癌的宣教工作，不断加强筛查与早诊早治的水平和措施，从而降低肝癌的发病和死亡风险。

关键词: 肝癌, 终生发病风险, 终生死亡风险