摘要目的:比较全球不同地区肝癌发病和死亡的地理差异和时间趋势，对未来肝癌负担进行预测。方法:收集GLOBOCAN 2020数据库中2000-2020年全球不同人类发展指数国家肝癌发病和死亡数据。使用joinpoint模型及年度百分比变化分析2000-2020年全球肝癌发病和死亡状况和未来流行趋势。结果:男性肝癌年龄标准化死亡率（ASMR）从2000年的8.0/10万到2015年7.1/10万（年度百分比变化= -0.7, 95% CI: -1.2~-0.3, P = 0.002)，女性肝癌ASMR从2000年的3.0/10万到2015年2.8/10万(年度百分比变化= -0.5, 95% CI: -0.8 ~-0.2， P < 0.001)。男女ASMR比例2000年为2.67∶1，2015年为2.51∶1，说明男女死亡率差异略有缩小。2020年全球肝癌ASIR和ASMR分别为9.5/10万和8.7/10万。男性年龄标准化发病率（ASIR）和ASMR（分别为14.1/10万和12.9/10万）是女性（分别为5.2/10万和4.8/10万）的2~3倍。不同人类发展指数国家和地区ASIR和ASMR存在显著差异（ PASIR = 0.008， PASMR < 0.001），ASMR分布和ASIR极其接近。预计2040年新发病例将增加58.6%（1 436 744例），死亡病例将增加60.9%（1 335 375例），其中亚洲发病数和死亡数分别增加397 003例和374 208例。 结论:2000-2015年，全球范围内由肝癌引起的ASMR呈下降趋势，但2020年肝癌最新流行病学现状及预测表明，未来20年肝癌防控在全球范围内仍然是一项重大挑战。

abstractsObjective:To compare the geographical differences and time trends of liver cancer incidence and mortality in different regions around the world so as to predict the future burden of liver cancer.Methods:The incidence and mortality data of liver cancer in different Human Development Index (HDI) countries from 2000 to 2020 were collected from the GLOBOCAN 2020 database. The joinpoint model and annual percent change (APC) were used to analyze the liver cancer global incidence and mortality as well as future epidemic trends from 2000 to 2020.Results:ASMR for male liver cancer was increased from 8.0/100, 000 in 2000 to 7.1/100,000 in 2015 (APC = -0.7, 95% CI: -1.2 ~ -0.3, P = 0.002), while ASMR for female liver cancer was increased from 3.0/100, 000 in 2000 to 2.8/100, 000 in 2015 (APC = -0.5, 95% CI: -0.8 ~ -0.2, P < 0.001). The ratio of male to female ASMR was 2.67:1 in 2000 and 2.51:1 in 2015, indicating a slight narrowing of the difference in mortality between men and women. In 2020, the global ASIR and ASMR for liver cancer were 9.5/100 000 and 8.7/100 000, respectively. Male ASIR and ASMR (14.1/100, 000 and 12.9/100, 000, respectively) were 2 ~ 3 times higher than females (5.2/100, 000 and 4.8/100, 000, respectively). There were significant differences between ASIR and ASMR in different HDI countries and regions ( PASIR = 0.008, PASMR < 0.001), and the distributions of ASMR and ASIR were very similar. New cases and deaths were expected to increase by 58.6% (143,6744) and 60.9% (133, 5 375) in 2040, with the number of cases and deaths increasing by 39,7003 and 37,4208 in Asia, respectively. Conclusion:ASMR due to liver cancer worldwide has had a downward trend between 2000 and 2015. However, the latest epidemiological status and predictions of liver cancer in 2020 indicate that prevention and control will still be a major challenge globally in the next 20 years.