基于GBD数据库的全球肝癌发病率地理分布特征及空间分布模式分析OA

Objective This research systematically analyzed the geographic distribution characteristics and spatial patterns of liver cancer across countries worldwide,incorporating gender differences,in order to reveal the spatial clustering and heterogeneity of global liver cancer incidence and to provide scientific evidence for optimizing global liver cancer prevention strategies and healthcare resource allocation.Methods Using age-standardized incidence rate(ASIR)of liver cancer from the Global Burden of Disease data-base 2021 for 200 countries,global and local Moran's Ⅰ spatial autocorrelation analyses were conducted using GeoDa1.8.12 software to assess the spatial clustering and distributional heterogeneity of liver cancer ASIR across different countries and gender groups(total population,males,and females).Results In 2021,the global liver cancer ASIR showed distinct geographic and gender disparities,with male liver cancer ASIRs higher than those of females in approximately 94%of countries.China ranked 29th in terms of liver cancer ASIR among 200 countries for the total population,24th for males,and 48th for females,indicating a considerable disease burden.Global spatial autocorrelation analysis indicated that the spatial clustering of male liver cancer ASIRs(Moran's Ⅰ=0.241,P=0.001)was stronger than that of female liver cancer ASIRs(Moran's Ⅰ=0.167,P=0.001).Local spatial autocorrelation identified 12 countries with high-high clustering of male liver cancer and 16 such countries for females,mainly located in Asia(e.g.,China,Democratic People's Republic of Korea)and parts of Africa(e.g.,Mali,Mauritania).In contrast,15 countries with low-low clustering for males and 18 for females were primarily distributed in Europe(e.g.,Slovakia,Cyprus)and North America(e.g.,the Bahamas,Cuba),with similar overall trends in the spatial distribution of clustering for both genders.Conclusion The global incidence of liver cancer exhibits marked spatial heterogeneity,characterized by high-incidence zones centered in East Asia and parts of Africa,and by low-incidence zones in regions such as Europe and North America,thus displaying typical spatial aggregation patterns.The challenge of liver cancer control in China remains substantial,necessitating continued reinforcement of hepatitis virus prevention,optimization of medical resource allocation,and promotion of early screening,diagnosis,and treatment for liver cancer.Globally,it is recommended to implement more precise and coordinated prevention strategies and to strengthen international collaboration,with the aim of enhanc-ing overall control effectiveness and reducing both the incidence and mortality of liver cancer.