The impact of universal hepatitis B vaccine on the trend of liver cancer from the Global Burden of Disease Study 2017

Burden of liver cancer attributable to high fasting plasma glucose: a global analysis based on the global burden of disease study 2019

OBJECTIVE

Liver cancer is the world's sixth most prevalent cancer and the third most frequent cause of cancer-related mortality. Glucose metabolic disorders, indicated by a high fasting plasma glucose (HFPG) concentration, is a contributor to the etiology of liver cancer. With the rising prevalence of glucose metabolic disorders, an assessment of the global burden of liver cancer attributable to HFPG is warranted to inform global liver cancer prevention and control strategies.

METHODS AND ANALYSIS

We evaluated the global death and disability-adjusted life years (DALYs) of liver cancer and its subtypes attributable to HFPG at global, regional, and country level. The temporal trend and disparity across geographic regions, social development level, age groups and sex were assessed.

RESULTS

In 2019, HFPG-attributable liver cancer was estimated to have caused 4,729.49 deaths and to be responsible for 99,302.25 DALYs. The age-standardized mortality and DALY rate were 0.06 and 1.20 per 100,000 population, and displayed a significantly increasing temporal trend from 1990 to 2019. The age-standardized mortality rate of patients with liver cancer that was attributable to HFPG was higher in men than women. Sex-based disparity narrowed after the women reached menopause, but increased between 1990 and 2019.

CONCLUSION

The burden of liver cancer that are attributable to HFPG has been influenced by longitudinal changes in lifestyle, the etiology of liver disease, age demographics, and hormonal status in women. These findings suggest that comprehensive strategies could be implemented, especially for patients with NASH and hyperglycemia, to prevent liver cancer.

Global Patterns and Trends in Total Burden of Hepatitis B from 1990 to 2019 and Predictions to 2030

BACKGROUND AND AIMS

Despite widespread vaccination against hepatitis B and availability of antiviral drugs, hepatitis B remained a major global public health problem. Therefore, an improved understanding of the burden of hepatitis B was required to help design strategies for global intervention.

METHODS

Data on hepatitis B was collected by the Global Burden of Disease (GBD) 2019 database from 1990 to 2019. Age-standardized incidence rates (ASIR), mortality rates (ASMR) and disability-adjusted life year rates (ASDR) for hepatitis B were extracted from GBD 2019 and stratified by age, level of regionals and country. Estimated annual percentage changes (EAPC) of ASIR, ASMR and ASDR were calculated to quantify the temporal trends in hepatitis B.

RESULTS

Globally, ASIR showed a continuous downward trend, from 1552.2 in 1990 to 1010.0 per 100,000 persons in 2019, with an annual decrease of 1.52% (95% CI -1.66--1.38). ASMR showed a persistent decline, declining by nearly half in 2019 compared to 1990 (6.7 vs 12.4 per 100,000 persons), with an annual decrease of 2.55% (95% CI -2.74--2.35). ASDR showed a continuing downward trend, and the EAPC was -2.55% (95% CI -2.74--2.35). This decreasing pattern was heterogeneous across regions and countries. Hepatitis B related deaths increased significantly in high socio-demographic index countries such as UK, USA, and Canada. The ARIMA model estimates a 36.14% and 6.00% decrease in ASIR and ASMR, respectively, by 2030 compared to 2015.

CONCLUSION

Global hepatitis B morbidity and mortality rates decreased significantly from 1990 to 2019, but with a high degree of heterogeneity among regions and countries. It was still far from achieving the WHO goal of elimination of viral hepatitis by 2030, especially mortality rate.

Comparison of primary liver cancer mortality estimates from World Health Organization, global burden disease and global cancer observatory

AIMS

This study aims to compare estimates of primary liver cancer mortality from World Health Organization (WHO), Global Burden Disease (GBD) and Global Cancer Observatory (GCO).

METHODS

Liver cancer mortality was extracted from WHO, GBD and GCO for 92 countries for the most recent year. Age-standardized rate (ASR) was computed and used for current comparisons across the three data sources. Temporal trend for 75 countries was analysed and compared between WHO and GBD from 1990 to 2019 using joinpoint regression. Average annual percentage change for the most recent 10 years was used as indicator for change.

RESULTS

The estimates of ASR were quite consistent across the three data sources, but most similar estimates were found between WHO and GCO in both region and country levels. The differences in ASR were negatively correlated with completeness of cause-of-death registration, human development index and proportion of liver cancer because of alcohol consumption. Consistent trends of ASR were found from 35 countries between WHO and GBD in the most recent 10 years. However, opposite trends were found from 10 countries with five from Southern America, four from Europe and one from Asia. Of the 18 countries for projection, opposite trends between WHO and GBD were found from seven countries.

CONCLUSION

While the ASR of primary liver cancer mortality was comparable across the three data sources, most similar estimates were found between WHO and GCO. The opposite trends found from 10 countries between WHO and GBD raised concerns of true patterns in these countries.

KSHV (HHV8) vaccine: promises and potential pitfalls for a new anti-cancer vaccine

Seven viruses cause at least 15% of the total cancer burden. Viral cancers have been described as the "low-hanging fruit" that can be potentially prevented or treated by new vaccines that would alter the course of global human cancer. Kaposi sarcoma herpesvirus (KSHV or HHV8) is the sole cause of Kaposi sarcoma, which primarily afflicts resource-poor and socially marginalized populations. This review summarizes a recent NIH-sponsored workshop's findings on the epidemiology and biology of KSHV as an overlooked but potentially vaccine-preventable infection. The unique epidemiology of this virus provides opportunities to prevent its cancers if an effective, inexpensive, and well-tolerated vaccine can be developed and delivered.

The impact of hepatitis B vaccination in the United States, 1999-2018

BACKGROUND AND AIMS

Hepatitis B vaccine has been included in the infant immunization schedule since 1991 in the United States. We aimed to assess its effectiveness against HBV infection and its impact on mortality.

APPROACH AND RESULTS

The study population was participants aged 6+ years with an HBV vaccination history and an HBV serologic test from the National Health and Nutrition Examination Survey, 1999-2018. Participants aged 18+ years with linked mortality records from 1999-2014 were followed for mortality analysis. Multivariable logistic regression was used to compute vaccine effectiveness (VE) overall, by year of birth, and by age. Cox regression was used to estimate HRs for all-cause, cancer-related, and cardiovascular disease-related mortality. A total of 64,107 participants were included in the main analysis, with 29,600 (40.7%) having completed HBV vaccination (three or more doses, vaccinated). The highest vaccination uptake was found among those born after 1991, at 86.5%. Vaccinated participants had higher prevalence of vaccine-induced immunity than the unvaccinated (47.2% vs. 7.4%). Among those born after 1991, VE was found at 58% (95% CI, 18%-79%) overall and 85% for those aged ≥20 years (mean age, 22), whereas no effect was found among those born prior to 1990. HBV vaccination was associated with reduced risk of all-cause mortality (HR, 0.78; 95% CI, 0.68-0.90) and cancer-related mortality (HR, 0.76; 95% CI, 0.58-1.00) but not for cardiovascular disease-related mortality.

CONCLUSIONS

In the universal infant vaccination era, the HBV vaccine has shown substantial effectiveness against HBV infection and maintained strong protection for 20 years. It was also associated with reduced risk of all-cause and cancer-related mortality.

circCORO1C promotes the proliferation and metastasis of hepatocellular carcinoma by enhancing the expression of PD-L1 through NF-κB pathway

BACKGROUND

Circular RNA (circRNA) affects the occurrence and development of human cancers, but the specific mechanism of hepatocellular carcinoma (HCC) has not yet been fully understood.

METHODS

CircRNAs were determined by human circRNA array analysis and quantitative reverse transcription polymerase chain reaction (qRT-PCR). Cell viability, migration, invasion, and other indicators were used for cell function analysis. Knockdown and overexpression techniques were used to explore the mechanism of circCORO1C in the occurrence and development of HCC by RNA sequencing, qRT-PCR, western blot, and other methods.

RESULTS

Among the thousands of circRNAs, 1238 circRNAs were significantly changed. As for the top 10 upregulated circRNAs, the expression of circRNAs, hsa_circ_0036412, hsa_circ_0036411, hsa_circ_0028071, hsa_circ_0036409, hsa_circ_0000437, hsa_circ_0021427, hsa_circ_0097182, hsa_circ_0028067, hsa_circ_0006852, and hsa_circ_0003620 were significantly increased. In regard to the top 10 downregulated circRNAs, the expression of hsa_circ_0123629, hsa_circ_0096121, hsa_circ_0038932, hsa-circRNA3310-44, hsa_circ_0045746, hsa_circ_0016836, hsa-circRNA10899-9, hsa_circ_0050116, hsa_circ_0035543, and hsa_circ_0092118 decreased significantly. About these circRNAs, the downregulation of hsa_circ_0006852 (circCORO1C) can inhibit the tumorigenesis of HCC cells in vivo and in vitro, and the overexpression of circCORO1C can enhance the proliferation and metastasis ability of HCC cells. Mechanistically, circCORO1C activated the NF-κB signaling pathway, increased P65 phosphorylation and upregulation of c-Myc and COX-2, leading to increased PD-L1 expression.

CONCLUSION

CircCORO1C upregulates c-Myc and COX-2 through NF-κB signaling pathway, leading to the upregulation of PD-L1, which jointly promotes the development of HCC, suggesting that circCORO1C is a promising biomarker and therapeutic target for HCC.

The Changing Demographics of Hepatitis B Virus Infection

Hepatitis B virus infection remains a global public health problem with changing epidemiology due to several factors including vaccination policies and migration.

Recent global burden of cervical cancer incidence and mortality, predictors, and temporal trends

BACKGROUNDS

This study investigated the global incidence and mortality of cervical cancer, its predictors, the temporal trend by country and age.

METHODS

Data from Global Cancer Observatory 2020 for 185 countries was used to estimate current cervical cancer incidence and mortality and their associations with predictors by linear regression analysis. Estimated age-standardized rates (ASR) and average annual percentage changes (AAPC) from cancer registries for up to 53 countries through 2018 were used for trend analysis by joinpoint regression.

RESULTS

Wide variations in cervical cancer were observed globally with the highest rates of incidence and mortality in East Africa (ASR, 40.1 and 28.6). The incidence and mortality of cervical cancer were positively associated with human papillomavirus, human immunodeficiency virus infection and negatively associated with cervical cancer screening coverage. In the most recent 5 years, reduction of incidence and mortality was found from 22 (AAPC, -11.2 to -0.5) and 27 countries (-21.5 to -0.3). Increase of incidence and mortality was found from 13 (1.7 to 6.5) and 5 (0.3 to 1.8) countries. Comparing to women aged above 50 years, increasing incidence were additionally found among women under age 50 years from 9 countries (ranging from 0.2 in Denmark to 3.8 in Sweden).

CONCLUSIONS

While most countries with cancer registry have shown reduction in cervical cancer incidence and mortality, the increasing incidence among younger women from some developed countries warrants further implementation of effective cancer screening.