Worldwide burden of liver cancer across middle-aged and elderly people, 1990-2021: a decomposition, cross-country inequality and frontier analysis

Objective Liver cancer is a significant contributor to the global disease burden. we first provide estimates of the worldwide burden of liver cancer from 2000 to 2021 in middle-aged and elderly people with decomposition, cross-country inequality and frontier analysis. Methods The age-standardized rate (ASR) and estimated annual percentage change (EAPC) were utilized for measuring prevalence, incidence, deaths and disability-adjusted life years (DALYs) rate trends. Decomposition, cross country inequalities and frontier analysis to estimate the burden. Results In 2021, the number of liver cancer prevalence and the incidence was increased compared to 1990, while the number of deaths and DALYs slightly decreased. The burden of liver cancer was higher in males than in females. Population growth led to an increase in the burden. Aging and epidemiological changes made significant contributions to the reduction of the liver cancer burden. There was a V-shaped relationship between the DALYs rate and SDI regions. There was a significant absolute inequality across countries. 15 countries and regions had considerable potential for improvement in reducing the burden . Conclusion This study reveals the complex dynamic changes in the global burden of liver cancer across middle-aged and elderly people. In the future, it is necessary to strengthen international cooperation, promote the fair distribution of medical resources, and formulate and implement differentiated strategies.