[Analysis and prediction of liver cancer mortality trends in Qidong City of China, 1972-2024].
Objective: To analyze the mortality trends of liver cancer in the general population of Qidong City, Jiangsu Province from 1972 to 2024, and to predict the mortality burden from 2025 to 2034, providing a basis for liver cancer prevention and control strategies. Methods: Liver cancer mortality data (1972-2024) were extracted from the Qidong Cancer Registry database. Using corresponding population data, we calculated: crude mortality rate (CR), Chinese age-standardized rate (ASRC, standardized using the 1964 Chinese population), world age-standardized rate (ASRW, standardized using Segi's world population), and median age at death. Joinpoint regression (Joinpoint 4.9.1.0) was employed to estimate annual percent change (APC) and average annual percent change (AAPC) in mortality, The ARIMA model in SAS 9.2 was applied to predict mortality trends over the next decade. Results: A total of 34 773 liver cancer deaths were recorded in Qidong from 1972 to 2024. Compared with 1972-1976, the proportion of liver cancer deaths among all cancer deaths in 2022-2024 decreased from 40.02% to 12.83%. The CR, ASRC, and ASRW declined from 49.33/105, 45.62/105, and 57.23/105 in 1972-1976 to 44.09/105, 8.54/105, and 13.91/105 in 2022-2024, respectively. The male-to-female ratio of ASRW was 3.33:1 from 1972 to 2024. For 2022-2024, the ASRW was 21.16/105 for males and 7.22/105 for females. Age-specific mortality rates showed declining trends in all age groups under 65 years from 1972 to 2024, with greater declines in younger age groups (all P＜0.05). In contrast, the mortality rate in the 75+ years age group showed an increasing trend (AAPC=2.15%, P=0.001). The median age at death from liver cancer in Qidong rose from 49 years in 1972 to 72 years in 2024, and the peak mortality age group shifted gradually from 45-54 years to 75+ years across periods. The time trend analysis revealed that from 1972 to 2024, the AAPCs for ASRW were -2.11%, -2.23%, and -1.89% (all P＜0.001) for both sexes combined, males, and females, respectively, all showing statistically significant downward trends. The CR showed a slow but significant increasing trend for females (AAPC=0.88%, P＜0.001), while the trends for both sexes combined and males were not statistically significant (all P＞0.05). Segmented fitting results showed the most pronounced decline occurred from 2008 to 2024, with an APC of -3.76% for CR and -7.15% for ASRW (both P＜0.001). The overall CR is projected to decline to 40.30/105 in 2034, and the ASRW is projected to decline to 4.40/105. Conclusions: The comprehensive prevention and control efforts implemented over 53 years in the high-incidence area of Qidong have influenced the overall standardized mortality rate and the liver cancer mortality rate among those under 65 years of age, with the most significant decline observed after 2008. Future efforts should focus on strengthening comprehensive prevention and control of liver cancer in the elderly population.