Background China is a country with a very heavy burden of liver cancer disease, and understanding the epidemiological characteristics and trends of liver cancer in China can help develop targeted public health strategies. Methods The data were retrieved from the Global Burden of Disease (GBD) Study 2021. The age-standardized incidence rate (ASIR) and age-standardized death rate (ASDR) were used to estimate the trends in the incidence of and deaths from liver cancer by sex, region, country, and etiology between 1990 and 2021. Additionally, the attributable risk factors for deaths and disability adjusted life years (DALYs) were assessed. Finally, the Bayesian age?period?cohort model was used to predict the ASIR and ASDR of liver cancer from 2022 to 2035. Results In China, from 1990 to 2021, the incidence of liver cancer increased from 96.43 thousand (95% UI: 80.97, 113.76) to 196.63 thousand (95% UI: 158.27, 243.55), and the number of deaths increased from 94.93 thousand (95% UI: 79.88, 111.52) to 172.06 thousand (95% UI: 139.62, 212.49). Moreover, the ASIR was 10.58 (95% UI: 8.94, 12.43) per 100,000 population in 1990 and 9.52 (95% UI: 7.72, 11.78) per 100,000 population in 2021, and the ASDR was 10.75 (95% UI: 9.12, 12.61) per 100,000 population in 1990 and 8.35 (95% UI: 6.80, 10.29) per 100,000 population in 2021. The peak number of liver cancer cases was concentrated in the population aged 65-69 years, but the incidence rate showed an obvious trend of increasing with age. Liver cancer due to hepatitis B was the most common type of cancer. Tobacco ranked first among risk factors, with rapidly increasing risk factors being drug use and high body mass index. In the next 15 years, the ASIR and ASDR will not decrease among people aged 60 and over. Conclusion With the aging of the population in China, liver cancer remains an important disease burden. Therefore, measures should be taken to target risk factors and high-risk groups.

The authors have declared no competing interest.

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Because the study was based on a publicly available dataset, this study was exempted by the ethics committee of the Second People's Hospital of Wuhu

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