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: 30 Mar 2025
Reviewer:  Jia-Jie Lv
Reviewer's report:
The article examines the trends, etiologies, and risk factors associated with liver cancer (LC) in
Cambodia from 1990 to 2021, utilizing data from the Global Burden of Disease (GBD) 2021
study. The study highlights the increasing burden of LC in terms of deaths, disability-adjusted
life years (DALYs), incidence, and prevalence, with significant variability based on gender, age,
and etiology. While the age-standardized rates (ASRs) for hepatitis B virus (HBV) and hepatitis
C virus (HCV)-associated LC have declined, alcohol-related LC has shown a steady increase.
The study also predicts future trends using ARIMA modeling, indicating a continued rise in
LC-related disease burden, particularly for alcoholic LC. It emphasizes the need for targeted
prevention strategies, including vaccination programs, lifestyle modifications, and risk factor
management, to mitigate the growing LC burden in Cambodia.
1.The abstract and conclusion are repetitive and overly detailed with numerical data, making
it harder for readers to quickly grasp the study's key findings and implications. Suggestion:
Simplify both sections by focusing on the most critical results and their public health
implications, while reserving detailed statistics for tables or results sections.
2.The introduction lacks a concise justification for why Cambodia's liver cancer
burden is uniquely significant compared to other Southeast Asian countries. Suggestion:
Emphasize Cambodia-specific challenges, such as historical healthcare limitations, changing
socioeconomic conditions, and high HBV/HCV prevalence rates, to better contextualize the
study.
3.The methodology does not clearly describe potential limitations in data collection, particularly
for historical data from the 1990s, which may be incomplete due to the post-conflict state
of Cambodia. Suggestion: Discuss the reliability of the GBD data for earlier years and how
potential biases from limited local data sources were addressed in the analysis.
4.The results section is overly detailed with numerical data for deaths, DALYs, and ASRs, which
can overwhelm readers and obscure key patterns or trends. Suggestion: Focus on summarizing
significant findings and trends, and present the detailed numerical data in tables or appendices
for reference.
5.There are grammatical errors and awkward phrasing throughout the manuscript, such as "in
females at 48.27 (95% UI: 22.08-83.54)." Conduct professional proofreading to improve clarity
and ensure grammatical correctness.
6.The policy recommendations are generic and lack specificity regarding Cambodia's unique
healthcare challenges and resource constraints. Please propose targeted interventions, such as
expanding access to affordable antiviral treatments, addressing alcohol consumption through
taxation or education programs, and increasing public awareness of modifiable risk factors like
obesity and smoking.
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: 30 Mar 2025
Reviewer:  Jia-Jie Lv
Reviewer's report:
The article examines the trends, etiologies, and risk factors associated with liver cancer (LC) in
Cambodia from 1990 to 2021, utilizing data from the Global Burden of Disease (GBD) 2021
study. The study highlights the increasing burden of LC in terms of deaths, disability-adjusted
life years (DALYs), incidence, and prevalence, with significant variability based on gender, age,
and etiology. While the age-standardized rates (ASRs) for hepatitis B virus (HBV) and hepatitis
C virus (HCV)-associated LC have declined, alcohol-related LC has shown a steady increase.
The study also predicts future trends using ARIMA modeling, indicating a continued rise in
LC-related disease burden, particularly for alcoholic LC. It emphasizes the need for targeted
prevention strategies, including vaccination programs, lifestyle modifications, and risk factor
management, to mitigate the growing LC burden in Cambodia.
1.The abstract and conclusion are repetitive and overly detailed with numerical data, making
it harder for readers to quickly grasp the study's key findings and implications. Suggestion:
Simplify both sections by focusing on the most critical results and their public health
implications, while reserving detailed statistics for tables or results sections.
2.The introduction lacks a concise justification for why Cambodia's liver cancer
burden is uniquely significant compared to other Southeast Asian countries. Suggestion:
Emphasize Cambodia-specific challenges, such as historical healthcare limitations, changing
socioeconomic conditions, and high HBV/HCV prevalence rates, to better contextualize the
study.
3.The methodology does not clearly describe potential limitations in data collection, particularly
for historical data from the 1990s, which may be incomplete due to the post-conflict state
of Cambodia. Suggestion: Discuss the reliability of the GBD data for earlier years and how
potential biases from limited local data sources were addressed in the analysis.
4.The results section is overly detailed with numerical data for deaths, DALYs, and ASRs, which
can overwhelm readers and obscure key patterns or trends. Suggestion: Focus on summarizing
significant findings and trends, and present the detailed numerical data in tables or appendices
for reference.
5.There are grammatical errors and awkward phrasing throughout the manuscript, such as "in
females at 48.27 (95% UI: 22.08-83.54)." Conduct professional proofreading to improve clarity
and ensure grammatical correctness.
6.The policy recommendations are generic and lack specificity regarding Cambodia's unique
healthcare challenges and resource constraints. Please propose targeted interventions, such as
expanding access to affordable antiviral treatments, addressing alcohol consumption through
taxation or education programs, and increasing public awareness of modifiable risk factors like
obesity and smoking.
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: 30 Mar 2025
Reviewer:  Jia-Jie Lv
Reviewer's report:
The article examines the trends, etiologies, and risk factors associated with liver cancer (LC) in
Cambodia from 1990 to 2021, utilizing data from the Global Burden of Disease (GBD) 2021
study. The study highlights the increasing burden of LC in terms of deaths, disability-adjusted
life years (DALYs), incidence, and prevalence, with significant variability based on gender, age,
and etiology. While the age-standardized rates (ASRs) for hepatitis B virus (HBV) and hepatitis
C virus (HCV)-associated LC have declined, alcohol-related LC has shown a steady increase.
The study also predicts future trends using ARIMA modeling, indicating a continued rise in
LC-related disease burden, particularly for alcoholic LC. It emphasizes the need for targeted
prevention strategies, including vaccination programs, lifestyle modifications, and risk factor
management, to mitigate the growing LC burden in Cambodia.
1.The abstract and conclusion are repetitive and overly detailed with numerical data, making
it harder for readers to quickly grasp the study's key findings and implications. Suggestion:
Simplify both sections by focusing on the most critical results and their public health
implications, while reserving detailed statistics for tables or results sections.
2.The introduction lacks a concise justification for why Cambodia's liver cancer
burden is uniquely significant compared to other Southeast Asian countries. Suggestion:
Emphasize Cambodia-specific challenges, such as historical healthcare limitations, changing
socioeconomic conditions, and high HBV/HCV prevalence rates, to better contextualize the
study.
3.The methodology does not clearly describe potential limitations in data collection, particularly
for historical data from the 1990s, which may be incomplete due to the post-conflict state
of Cambodia. Suggestion: Discuss the reliability of the GBD data for earlier years and how
potential biases from limited local data sources were addressed in the analysis.
4.The results section is overly detailed with numerical data for deaths, DALYs, and ASRs, which
can overwhelm readers and obscure key patterns or trends. Suggestion: Focus on summarizing
significant findings and trends, and present the detailed numerical data in tables or appendices
for reference.
5.There are grammatical errors and awkward phrasing throughout the manuscript, such as "in
females at 48.27 (95% UI: 22.08-83.54)." Conduct professional proofreading to improve clarity
and ensure grammatical correctness.
6.The policy recommendations are generic and lack specificity regarding Cambodia's unique
healthcare challenges and resource constraints. Please propose targeted interventions, such as
expanding access to affordable antiviral treatments, addressing alcohol consumption through
taxation or education programs, and increasing public awareness of modifiable risk factors like
obesity and smoking.
assistant