Disease burden and prediction of liver cancer attributable to metabolic risks in five East Asian countries from 1990 to 2023.
Liver cancer is a major public health issue in five East Asian countries, with metabolic factors becoming primary drivers. Based on the Global Burden of Disease (GBD) 2023 database, we extracted the total number and age-standardized mortality rates, years lived with disability (YLDs), years of life lost (YLLs) and disability-adjusted life years (DALYs) related to liver cancer attributable to metabolic risks (LC-MR). We analyzed the disease burden of LC-MR and trends across five East Asian countries from 1990 to 2023, examining patterns by sex and age as well as key drivers across different nations, and projected future trends through 2053. In 2023, Mongolia exhibited the highest age-standardized rates for LC-MR, while China ranked first in the total absolute number of cases. From 1990 to 2023, the overall disease burden showed a downward trend in Japan and Republic of Korea, whereas an upward trend was observed in Mongolia, Democratic People's Republic of Korea, and China. Significant sex and age disparities were observed across all countries in that males bore a higher burden and the burden generally shifted towards the elderly population. Decomposition analysis revealed that the changes in disease burden in Japan and Republic of Korea were primarily driven by population ageing, whereas the main drivering factors were epidemiological changes and population growth in Mongolia and Democratic People's Republic of Korea. Projections of disease burden for 2053 indicate that the disparities among countries would further widen. Therefore, strengthening metabolic risk interventions and implementing targeted prevention strategies for high-risk populations, especially the aging population, is crucial for reducing the regional burden of LC-MR, given the risk disparities across different countries.