Contribution of alcohol use to the global burden of cirrhosis and liver cancer from 1990 to 2019 and projections to 2044

Abstract

Background Identifying the temporal trends of cirrhosis and liver cancer attributable to alcohol use in both the past and the future can formulate the control strategies. Methods Data on cirrhosis and liver cancer attributable to alcohol use from 1990 to 2019, including mortality and disability-adjusted life year (DALY) rates were collected from the 2019 Global Burden of Disease (GBD) study. To analyze the temporal trends, the average annual percentage change (AAPC) was calculated, and the Bayesian age-period-cohort model was applied. Result Deaths and DALY of cirrhosis and liver cancer attributable to alcohol use increased year by years, but the age-standardized death rate (ASDR) and age-standardized DALY rate declined or remained stable from 1990 to 2019 in most regions of the world. The burden of cirrhosis attributable to alcohol increased in low-middle social-development index (SDI) regions, while the burden of liver cancer increased in high-SDI regions. Eastern Europe and Central Asia have the highest burden of cirrhosis and liver cancer caused by alcohol use. Deaths and DALYs are mainly distributed in people aged 40+ years, but there is an increasing trend in people aged under 40 years. New deaths from cirrhosis and liver cancer attributable to alcohol use are predicted to increase in the next 25 years, but the ASDR of cirrhosis in males will increase slightly. Conclusions Although the age-standardized rate of cirrhosis and liver cancer due to alcohol use have decreased, the absolute burden increased and will continue to increase. Therefore, alcohol control measures should be further strengthened and improved through effective national policies.

Changing spectrum and mortality disparities of etiology of liver cirrhosis in Beijing, China

“…Additionally, a remarkable decrease in DC‐related mortality was observed for patients hospitalized in recent years. The major contributors to this reduction might be regular monitoring of liver function, continual enhancing effective therapy for eligible patients, and controlling risk factors, such as alcohol abstinence 25,26 …”

Global burden of cirrhosis and liver cancer due to alcohol: the past, present, and the future

“…In this issue, Liu et al report on the global burden of ALD-cirrhosis and LC between 1990 and 2019, and have made projections on the ALD global burden until 2044 [ 5 ]. The investigators in this study analyzed data from 204 countries in the Global Burden of Disease (GBD) database to examine the outcomes of mortality and DALY rates attributable to ALD cirrhosis and LC.…”

“…Liu et al utilized the data prior to COVID pandemic with the Bayesian age-period-cohort model to predict that new deaths from ALD-cirrhosis and LC could increase in the next 25 years [ 5 ]. The COVID-19 pandemic, which started shortly after the data collection completion, has had a significant impact on healthcare systems worldwide.…”

“…Eastern Europe and Central Asia had the highest burden of ALD-cirrhosis and LC. Although, the deaths and DALYs were mainly distributed among people aged over 40, an increasing trend was noted in people under 40 years old [ 5 ].…”

“…Using pre-Covid-19 data, Liu et al also showed that new deaths from ALD-cirrhosis and LC are projected to increase in the next 25 years until 2044 [ 5 ]. The COVID-19 pandemic, which started in March 2020, has had a significant impact on healthcare systems worldwide, which has been and continues to be compounded by an increase in alcohol consumption and reduced access to treatment during the pandemic [ 7 ].…”