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Maryam HasanZarini 
, Amir Mohammad Salehi , Fatemeh Shahbazi *1 , Maryam Nikoofar , Gholamreza Kalvandi
, Amir Mohammad Salehi , Fatemeh Shahbazi *1 , Maryam Nikoofar , Gholamreza Kalvandi
1- , shahbazif2017@gmail.com
Abstract: (44 Views)
Background and Objectives: Hepatoblastoma is the most common primary malignant liver tumor in children; however, comprehensive national evidence regarding its epidemiological trends and disease burden in Iran remains limited. This study aimed to evaluate the temporal trends in incidence, prevalence, mortality, and disease burden of hepatoblastoma among Iranian children and adolescents from 1990 to 2023.
Methods: This ecological time-trend study was conducted using data from the Global Burden of Disease (GBD) 2023 study. Children and adolescents aged 0–19 years were included. The analyzed indicators comprised the number and age-standardized rates (ASRs) of incidence, prevalence, mortality, disability-adjusted life years (DALYs), years of life lost (YLLs), and years lived with disability (YLDs). Temporal trends were assessed using Joinpoint Regression Program version 4.9.1.0, and annual percent change (APC) and average annual percent change (AAPC) were estimated. Geographic variations in disease burden across Iranian provinces in 2023 were also evaluated using ArcMap version 10.8.
Results: Between 1990 and 2023, the number of incident cases showed an overall decreasing trend (AAPC = −1.71%), whereas prevalent cases increased (AAPC = +3.23%). The numbers of deaths, DALYs, and YLLs declined by an average of 3.58%, 3.49%, and 3.55% per year, respectively, while YLDs increased modestly (AAPC = +0.94%). Age-standardized incidence, mortality, DALYs, and YLLs also declined (AAPCs: −1.86%, −5.51%, −3.85%, and −3.96%, respectively), whereas age-standardized prevalence and YLDs increased by 3.96% and 1.57% per year, respectively. The largest increase in age-standardized prevalence occurred during 2014–2020 (APC = +15.07%). Geographically, the highest disease burden was observed in Sistan and Baluchistan, Kermanshah, Ilam, and Charmahal and Bakhtiari provinces, whereas Alborz, Mazandaran, and Gilan had the lowest burden. The strong spatial overlap between DALYs and YLLs indicated that premature mortality remains the predominant contributor to the overall disease burden.
Conclusions: Although the burden of hepatoblastoma in Iran has substantially declined over the past three decades, particularly in terms of mortality, DALYs, and YLLs, the concurrent increase in prevalence and YLDs reflects improved survival and a gradual shift in disease burden from premature mortality to long-term survivorship with treatment-related sequelae. These findings underscore the need to strengthen survivorship care programs, reduce regional disparities in access to specialized pediatric oncology services, and enhance cancer registration systems to improve long-term outcomes for children with hepatoblastoma.
Methods: This ecological time-trend study was conducted using data from the Global Burden of Disease (GBD) 2023 study. Children and adolescents aged 0–19 years were included. The analyzed indicators comprised the number and age-standardized rates (ASRs) of incidence, prevalence, mortality, disability-adjusted life years (DALYs), years of life lost (YLLs), and years lived with disability (YLDs). Temporal trends were assessed using Joinpoint Regression Program version 4.9.1.0, and annual percent change (APC) and average annual percent change (AAPC) were estimated. Geographic variations in disease burden across Iranian provinces in 2023 were also evaluated using ArcMap version 10.8.
Results: Between 1990 and 2023, the number of incident cases showed an overall decreasing trend (AAPC = −1.71%), whereas prevalent cases increased (AAPC = +3.23%). The numbers of deaths, DALYs, and YLLs declined by an average of 3.58%, 3.49%, and 3.55% per year, respectively, while YLDs increased modestly (AAPC = +0.94%). Age-standardized incidence, mortality, DALYs, and YLLs also declined (AAPCs: −1.86%, −5.51%, −3.85%, and −3.96%, respectively), whereas age-standardized prevalence and YLDs increased by 3.96% and 1.57% per year, respectively. The largest increase in age-standardized prevalence occurred during 2014–2020 (APC = +15.07%). Geographically, the highest disease burden was observed in Sistan and Baluchistan, Kermanshah, Ilam, and Charmahal and Bakhtiari provinces, whereas Alborz, Mazandaran, and Gilan had the lowest burden. The strong spatial overlap between DALYs and YLLs indicated that premature mortality remains the predominant contributor to the overall disease burden.
Conclusions: Although the burden of hepatoblastoma in Iran has substantially declined over the past three decades, particularly in terms of mortality, DALYs, and YLLs, the concurrent increase in prevalence and YLDs reflects improved survival and a gradual shift in disease burden from premature mortality to long-term survivorship with treatment-related sequelae. These findings underscore the need to strengthen survivorship care programs, reduce regional disparities in access to specialized pediatric oncology services, and enhance cancer registration systems to improve long-term outcomes for children with hepatoblastoma.
Keywords: Hepatoblastoma, Pediatric liver cancer, Disease burden, Incidence, Mortality, Disability-adjusted life years (DALYs), Joinpoint regression, Global Burden of Disease (GBD), Iran.
Type of Study: Research Article |
Subject:
Biostatistic & Epidemiology
Received: 2026/07/2 | Accepted: 2026/08/24
Received: 2026/07/2 | Accepted: 2026/08/24
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