确定非酒精性脂肪性肝炎（NASH）相关肝癌（NALC）过去的时间趋势，可以增加公众对该疾病的认识并促进未来政策的制定。本研究收集了1990年至2019年全球疾病负担（GBD）2019研究的NALC年死亡人数和年龄标化死亡率（ASDR）。采用Joinpoint分析来检测NALC死亡率的长期趋势和关键拐点，采用年龄-期间-队列分析来评估年龄、期间和队列的影响。最后，使用分解分析来揭示NALC负担的老龄化和人口增长效应。 从1990年至2019年，全球范围内NALC的ASDR呈整体下降趋势，女性呈下降趋势，男性呈稳定趋势。然而，从2010年至2019年，全球ASDR呈显著上升趋势。南撒哈拉以南非洲和东南亚的NALC负担最高，而高社会人口指数（SDI）地区在30年内NALC负担增长最快。分解分析显示，人口增长和老龄化是全球NALC死亡人数增加的主要推动因素。年龄-期间-队列分析显示，在高SDI地区，40-45岁女性NALC死亡率下降最快，同时伴随着2010年至2019年期间的趋势恶化。 过去十年，全球NALC的绝对死亡人数和ASDR均有所增加，不同性别、年龄和地区的人群之间存在显著差异。人口增长、老龄化和与代谢相关的因素是全球NALC死亡人数增加的主要因素。 （2023年版权所有。日本胃肠病学会。）

Identifying past temporal trends in non-alcoholic steatohepatitis (NASH)-associated liver cancer (NALC) can increase public awareness of the disease and facilitate future policy development.Annual deaths and age-standardized death rates (ASDR) for NALC from 1990 to 2019 were collected from the Global Burden of Disease (GBD) 2019 study. The long-term trend and the critical inflection of mortality of NALC were detected by Joinpoint analysis. Age-period-cohort analysis was employed to evaluate the effects of age, period, and cohort. Last, decomposition analysis was used to reveal the aging and population growth effects for NALC burden.Between 1990 and 2019, the ASDR of NALC witnessed an overall declining trend on a global scale, with a decrease in females and a stable trend in males. However, the global ASDR demonstrated a significant upward trend from 2010 to 2019. Southern sub-Saharan Africa and Southeast Asia have the highest NALC burdens, while high socio-demographic index (SDI) region experienced the fastest escalation of NALC burdens over 30 years. The decomposition analysis revealed that population growth and aging were the primary catalysts behind the increase in global NALC deaths. Age-period-cohort analyses showed that NALC mortality declined the fastest among females aged 40-45 years in high SDI region, accompanied by a deteriorating period effect trend during the period of 2010-2019.The global absolute deaths and ASDR of NALC have witnessed a rise in the past decade, with populations exhibiting considerable disparities based on sex, age, and region. Population growth, aging, and metabolism-related factors were the main factors behind the increase in global NALC deaths.© 2023. Japanese Society of Gastroenterology.