Primary liver cancer continues to pose a major global health challenge, ranking as the third leading cause of cancer-related deaths worldwide. Despite advances in treatment and prevention, both incidence and mortality remain alarmingly high, with nearly 870,000 new cases reported in 2022 alone. Hepatocellular carcinoma accounts for nearly 80% of these cases. Notably, China accounts for over 40% of the global burden, reflecting both historical exposure to viral hepatitis and emerging lifestyle-related risks. Increasingly, researchers are observing a critical epidemiological transition—from infectious causes such as hepatitis B and C to metabolic dysfunction-associated steatotic liver disease (MASLD), a condition linked to obesity, diabetes, and metabolic disorders.
Addressing this challenge, a research team was led by Professor Jian Zhou and Dr. Ao Huang, from the Department of Hepatobiliary Surgery and Liver Transplantation at the Liver Cancer Institute, Zhongshan Hospital, Fudan University, China, along with Professor Dan G. Duda from the Steele Laboratories for Tumor Biology, Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, USA. The team conducted a comprehensive analysis using global cancer databases, including GLOBOCAN 2022 and the Global Burden of Disease (GBD) study, integrating epidemiological, demographic, and etiological risk factor data to identify key trends and drivers of liver cancer worldwide and in China. The findings were first published online on March 27, 2026, and later published in Volume 5, Issue 1 of Portal Hypertension & Cirrhosis on March 31, 2026.
The study reveals that while age-standardized incidence and mortality rates have shown slight declines over recent decades, the absolute number of cases is projected to rise dramatically, reaching over 1.5 million annually by 2050 if current trends persist. This increase is largely driven by the growing prevalence of MASLD, which is emerging as a major contributor alongside traditional causes such as hepatitis infections. Although widespread hepatitis B vaccination and antiviral therapies have successfully reduced virus-related liver cancer rates, metabolic risk factors, including obesity, diabetes, poor diet, and physical inactivity, are rapidly becoming dominant drivers.
At the same time, the study highlights striking disparities across regions and populations. Higher incidence and mortality rates are concentrated in low- and middle-income regions, where limited access to vaccination, screening, and treatment exacerbates outcomes. Risk is higher among men, older adults, and socioeconomically disadvantaged populations. Environmental exposures, particularly aflatoxin contamination in food, continue to play a significant role in certain regions, compounding existing risks.
“Liver cancer is increasingly shaped by preventable and modifiable factors ,” said Prof. Zhou. “This shift presents both a challenge and an opportunity—while the disease burden may grow, a large proportion of cases could be avoided through targeted interventions. ”
The researchers emphasize that up to 60% of liver cancer cases are preventable through strategies such as vaccination, lifestyle modification, improved food safety, and early disease management. In the short term, these findings could inform public health campaigns promoting healthier diets, physical activity, and routine screening for high-risk individuals. In the longer term, the integration of artificial intelligence into clinical care could transform liver cancer management, enabling personalized risk prediction, earlier diagnosis, and more effective treatment planning, particularly in resource-limited settings where early detection remains challenging.
“By combining prevention, early detection, and technological innovation, we have the tools to significantly reduce liver cancer mortality over the next decade,” Dr. Huang noted .
“However, equitable access to these interventions will be key to achieving meaningful global impact,” Prof. Duda further highlights.
Beyond clinical implications, this research is expected to drive interdisciplinary collaborations across public health, oncology, data science, and policy sectors. It underscores the need for coordinated global efforts to address both infectious and metabolic health challenges, particularly in rapidly developing regions. Over the longer term, such integrated strategies could lead to earlier diagnoses, improved survival rates, and reduced healthcare costs, ultimately reducing the global burden of liver cancer.
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Reference
DOI: 10.1002/poh2.70033
About Fudan University
Fudan University is a leading comprehensive research university based in Shanghai, China. Established in 1905, it is widely recognized for its academic excellence, rigorous scholarship, and strong emphasis on interdisciplinary research. The university offers a broad spectrum of programs across the humanities, social sciences, natural sciences, engineering, and medicine. Fudan maintains extensive international collaborations and is consistently ranked among the top institutions in Asia, reflecting its commitment to advancing knowledge, innovation, and global engagement.
Website: https://www.fudan.edu.cn/en/
About Professor Jian Zhou from Fudan University, China
Prof. Jian Zhou is President of Zhongshan Hospital, Fudan University, and Professor of Liver Surgery and Liver Transplantation. He also serves as Executive Vice Director of the Liver Cancer Institute, Fudan University, and Vice Director of the Key Laboratory of Carcinogenesis and Cancer Invasion. A Fellow of the Chinese Academy of Medical Sciences, he is a recipient of the National Science Fund for Distinguished Young Scholars and a Changjiang Distinguished Professor. With over 10,000 hepatectomies and 2,000 liver transplants, he has led major national projects, published extensively (h-index 79), and received multiple national awards for scientific innovation.
About Dr. Ao Huang from Fudan University, China
Dr. Ao Huang is a medical doctor and researcher at Zhongshan Hospital, Fudan University, Shanghai, China, and is also affiliated with the Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Shanghai, China. He holds an MD and a PhD and has contributed to oncology and tumor biology research. With seven publications and 337 citations, his work focuses on cancer cell behavior and tumor progression. His research explores liver cancer, colorectal cancer, and metastatic disease, along with molecular mechanisms driving cancer development. He also investigates potential therapeutic strategies to better understand and target tumor growth and metastasis.
About Professor Dan G. Duda from Harvard Medical School, USA
Prof. Dan G. Duda is a Professor at the Steele Laboratories for Tumor Biology in the Department of Radiation Oncology at Massachusetts General Hospital and Harvard Medical School, USA. He earned a DMD from the University of Medicine in Iasi, Romania, and a PhD from Tohoku University in Japan. His research focuses on tumor microenvironment interactions and therapy resistance in gastrointestinal cancers. He has authored over 300 publications and ranks among the top 2% of scientists globally. He is widely recognized for advancing translational oncology and combination therapy strategies and holds leadership roles in major international cancer organizations.
Funding Information
This work was jointly funded by the Original Discovery Program of the National Natural Science Foundation of China (82150004), the National Natural Science Foundation of China (82488101, 82341027, 82072715, 82473484, and 82503253), the Noncommunicable Chronic Diseases‐National Science and Technology Major Project (2024ZD0525400, 2024ZD0525406), the Shanghai Municipal Science and Technology Major Project, the Shanghai Municipal Health Commission Collaborative Innovation Cluster Project (2019CXJQ02 and 201940075), the Shanghai Municipal Health Commission (2022LJ005), the Shanghai Science and Technology Commis sion (21140900300), Shanghai Sailing Program (24YF2705500), China Post doctoral Science Foundation (2024M760563), the Outstanding Resident Clinical Postdoctoral Program of Zhongshan Hospital Affiliated with Fudan University, the Eastern Talent Program (Leading project), and Key Project of Fudan University′s Medical Science Popularization Innovation (FDKP2024‐ 01). Dan G Duda′s research is supported by US National Institutes of Health (NIH) grants R01CA260857, R01CA260872, R01CA247441, R03CA256764, and P01CA261669, Department of Defense PRCRP Impact Award CA220079, and a Katz Investigator Award.
Portal Hypertension & Cirrhosis
Data/statistical analysis
People
Primary Liver Cancer Trends Worldwide and in China: Analysis of GLOBOCAN 2022 Data and Disease Management Implications
31-Mar-2026
The authors declare no conflicts of interest.