Title: Primary Liver Cancer Disease Burden in Cambodia During 1990-2021: A Systematic
Analysis of Datasets from the Global Burden of Disease Study 2021
Version: 1 Date: 01 Apr 2025
Reviewer's report:
Review
This study provides a well-structured, data-driven analysis of liver cancer trends in Cambodia,
offering valuable insights for public health strategies. Several recommendations require more
thorough clarified:
1. The analysis lacks an analysis of interactions between risk factors (e.g., obesity + alcohol
consumption).
2. The explanation for Cambodia's lower NAFLD-related LC rates (attributed to poverty and
malnutrition) remains speculative without direct evidence. Similarly, gender disparities in HCV
burden are discussed but lack thorough validation through relevant literature.
3. The causal relationship between female drug use and HCV lacks definitive evidence. The
reported higher burden of HCV-related LC in women contradicts existing literature. Further
exploration of biological factors (e.g., hormonal influences) and sociostructural factors (e.g.,
injection practices) is needed to validate these findings.
4. Intervention recommendations are overly generic. More tailored strategies should align
with study findings (e.g., targeted HBV/HCV screening for high-risk groups, alcohol taxation
policies, or gender-specific harm reduction programs).
5. Comparisons with other regions regarding alcohol-related LC or NAFLD-related LC trends
could enhance the context and highlight the uniqueness of Cambodia.
6. Generalizability and relevance to regions with similar characteristics remains unclear. The
study should address whether its findings hold broader applicability or reference value for
comparable settings.
Title: Primary Liver Cancer Disease Burden in Cambodia During 1990-2021: A Systematic
Analysis of Datasets from the Global Burden of Disease Study 2021
Version: 1 Date: 01 Apr 2025
Reviewer's report:
Review
This study provides a well-structured, data-driven analysis of liver cancer trends in Cambodia,
offering valuable insights for public health strategies. Several recommendations require more
thorough clarified:
1. The analysis lacks an analysis of interactions between risk factors (e.g., obesity + alcohol
consumption).
2. The explanation for Cambodia's lower NAFLD-related LC rates (attributed to poverty and
malnutrition) remains speculative without direct evidence. Similarly, gender disparities in HCV
burden are discussed but lack thorough validation through relevant literature.
3. The causal relationship between female drug use and HCV lacks definitive evidence. The
reported higher burden of HCV-related LC in women contradicts existing literature. Further
exploration of biological factors (e.g., hormonal influences) and sociostructural factors (e.g.,
injection practices) is needed to validate these findings.
4. Intervention recommendations are overly generic. More tailored strategies should align
with study findings (e.g., targeted HBV/HCV screening for high-risk groups, alcohol taxation
policies, or gender-specific harm reduction programs).
5. Comparisons with other regions regarding alcohol-related LC or NAFLD-related LC trends
could enhance the context and highlight the uniqueness of Cambodia.
6. Generalizability and relevance to regions with similar characteristics remains unclear. The
study should address whether its findings hold broader applicability or reference value for
comparable settings.
Please review this paper.
user
Title: Primary Liver Cancer Disease Burden in Cambodia During 1990-2021: A Systematic
Analysis of Datasets from the Global Burden of Disease Study 2021
Version: 1 Date: 01 Apr 2025
Reviewer's report:
Review
This study provides a well-structured, data-driven analysis of liver cancer trends in Cambodia,
offering valuable insights for public health strategies. Several recommendations require more
thorough clarified:
1. The analysis lacks an analysis of interactions between risk factors (e.g., obesity + alcohol
consumption).
2. The explanation for Cambodia's lower NAFLD-related LC rates (attributed to poverty and
malnutrition) remains speculative without direct evidence. Similarly, gender disparities in HCV
burden are discussed but lack thorough validation through relevant literature.
3. The causal relationship between female drug use and HCV lacks definitive evidence. The
reported higher burden of HCV-related LC in women contradicts existing literature. Further
exploration of biological factors (e.g., hormonal influences) and sociostructural factors (e.g.,
injection practices) is needed to validate these findings.
4. Intervention recommendations are overly generic. More tailored strategies should align
with study findings (e.g., targeted HBV/HCV screening for high-risk groups, alcohol taxation
policies, or gender-specific harm reduction programs).
5. Comparisons with other regions regarding alcohol-related LC or NAFLD-related LC trends
could enhance the context and highlight the uniqueness of Cambodia.
6. Generalizability and relevance to regions with similar characteristics remains unclear. The
study should address whether its findings hold broader applicability or reference value for
comparable settings.
assistant