Objective:

To evaluate the global burden of liver cancer from 1990 to 2021 and project its change to 2040, highlighting the significance of these findings for public health.

Key Findings:

• In 2021, global incident cases of liver cancer included 211,460 NASH-related, 1,031,830 HBV-related, 770,310 HCV-related, 497,720 alcohol-related cases, and 114,460 cases from other causes.
• HBV-related liver cancer had the highest age-standardized rates of incidence (2.62 per 100,000), deaths (2.30 per 100,000), and DALYs (71.83 per 100,000).
• The 65–69 age group bore the heaviest burden, predominantly from HBV-related cases.
• Higher sociodemographic indices correlated with greater burden for most liver cancer subtypes.
• Projections to 2040 indicate rising burdens for all subtypes except hepatoblastoma, with a 51.97% increase in NASH-related cases.

Interpretation:

The global burden of liver cancer is increasing, particularly for HBV and NASH-related cases, highlighting the need for enhanced public health strategies to mitigate this trend.

Limitations:

• Cross-country inequalities in liver cancer burden persist, and data may not fully capture regional variations or emerging trends, potentially leading to biases in understanding the true burden.

Conclusion:

There is an urgent need for interdisciplinary collaboration and public health measures to address the growing challenge of liver cancer, particularly in light of the disparities identified.