Objective  To analyze the incidence and mortality of liver cancer in China between 1992 and 2021, in order to provide data support for the prevention and treatment of liver cancer in the country. Methods Using the Global Burden of Disease (2021) database, we analyzed the trends and performed an age-period-cohort model analysis on the incidence and mortality of liver cancer by gender in China between 1992 and 2021. An autoregressive integrated moving average model was employed to forecast the age-standardized incidence and mortality rates of liver cancer in China from 2022 to 2030. Results Compared with 1992, the number of incident cases and deaths from liver cancer in China in 2021 increased significantly in the total population, males, and females. The percentage changes in the number of cases were 93.98% (101 400→196 700), 94.06% (74 100→143 800), and 93.41% (27 300→52 800), respectively. The corresponding percentage changes in the number of deaths were 75.25% (98 200→172 100), 72.29% (71 100→122 500), and 83.70% (27 000→49 600). The rate of change in incidence for the total population, males, and females in 2021 was 64.33% (8.41 per 100 000→13.82 per 100 000), 66.11% (11.89 per 100 000→19.75 per 100 000), and 62.61% (4.68 per 100 000→7.61 per 100 000), respectively; the rate of change in mortality was 48.53% (8.14 per 100 000→12.09 per 100 000), 47.41% (11.41 per 100 000→16.82 per 100 000), and 53.88% (4.64 per 100 000→7.14 per 100 000), respectively. The standardized incidence rates decreased compared to 1992, with changes of –9.16% (10.48 per 100 000→9.52 per 100 000), –4.14% (14.96 per 100 000→14.34 per 100 000), and –17.54% (5.93 per 100 000→4.89 per 100 000) for the total population, males, and females, respectively; the standardized mortality rates decreased by –20.32% (10.48 per 100 000→8.35 per 100 000), –16.61% (14.87 per 100 000→12.40 per 100 000), and –24.84% (6.08 per 100 000→4.57 per 100 000), respectively. The age effect showed significant variations in liver cancer risk with age, with the highest incidence risk in the 65–69 age group for the total population and females, and the 60–64 age group for males. The period effect overall showed an upward trend, with the most significant increase occurring from 2017 to 2021. The cohort effect indicated significant variations in liver cancer risk across different birth cohorts, with an overall increasing trend for the total population and females born between 1907 and 1981, and the most significant risk increase for males born between 1952 and 1956. The incidence and mortality risk for those born between 2017 and 2021 showed a significant downward trend. The prediction results indicated a continuous decline in liver cancer incidence and mortality rates for the total population, males, and females in China from 2022 to 2030. Conclusions From 1992 to 2021, the incidence and mortality rates of liver cancer in China increased, while the standardized incidence and mortality rates showed a decreasing trend. Age, period, and cohort are significant factors influencing liver cancer. It is essential to further strengthen liver cancer prevention and control strategies and vaccine implementation.

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