Abstract: Objective To comprehensively evaluate the disease burden and prevalence trend of non-alcoholic steatohepatitis associated hepatocellular carcinoma (NASH-HCC) in China from 1990 to 2019. Methods Using the Database of Global Burden of Disease Study 2019 and Joinpoint regression model, we explored the influences of factors such as age, gender, period, smoking, and high fasting plasma glucose on the disease burden of NASH-HCC in China from 1990 to 2019. What's more, the differences of disease burden were compared between China, the United States, and the world at the same period. Results The standardized prevalence rate of NASH-HCC in China increased by 1.55% from 1990 to 1996, decreased by 3.89% from 1996 to 2001, decreased by 16.25% from 2001 to 2005, and increased by 3.39% from 2010 to 2019. With the same changing trend of non-alcoholic fatty liver disease burden in China during the same period. Meanwhile, it was with a higher disease burden in males and older people. The two increases indicated the importance of factors including of medical level, diet structure, and lifestyle in the change of NASH-HCC burden. Smoking and high fasting plasma glucose had the greatest impacts on disease burden in males aged 65-69 years. Although the burden of disease in the United States was rising, and with a higher prevalence rate than in China, there was a higher level of overall burden of NASH-HCC in China than the global. Conclusions The disease burden of NASH-HCC is a major public health challenge in China. The government and individuals should pay more attention.

Key words: Non-alcoholic steatohepatitis associated hepatocellular carcinoma, Disease burden, Data analysis