Clustering asian countries according to the trend of liver cancer mortality rates: An application of growth mixture models

Abstract

Background: Liver cancer is considered as the 6th common cancer from which people are suffering all around the world. Poor prognosis is the main challenge regarding this disease. Objectives: The aim of this study was to compare the changing trends in the liver cancer death rate in Asian countries from 1990 to 2015. Methods: This ecological longitudinal study was performed to compare the death rate resulting from liver cancer. The data were gathered from all Asian countries provided by the global burden of disease’s (GBD) online database in the global health research center at the University of Washington published in October 2016. The classification was done based on the death rate using the growth mixed model (GMM). Results: The rate of liver cancer death in men was higher than women, there were 2 optimal classes. Both classes had an increasing trend. The first class had a steeper slope by a higher intercept. Taiwan, Thailand, Mongolia, North Korea, South Korea, China, and Japan were countries classified in this class. The mean of the intercept was estimated as 21.1 deaths per 100,000 people and the mean of the slope was 2.4. The other class had an increasing rate with a lower slope. Conclusions: In general, our statistical analyses showed that most Asian countries had an increasing trend in the rate of their liver cancer mortality. Therefore, it is highly recommended that officials in the health policy-making identify the reasons for the increase in the mortality rate and take due actions such as interventional programs of countries which have succeeded in taking under control the ramifications of liver cancer.