Pojsakorn Danpanichkul, Yanfang Pang, Tanuj Mahendru, Primrose Tothanarungroj, Luis Antonio Díaz, Juan Pablo Arab, Pimtawan Jatupornpakdee, Mark D. Muthiah, Kwanjit Duangsonk, Won-Mook Choi, Daniel Q. Huang, Donghee Kim, Mazen Noureddin, Karn Wijarnpreecha, Suthat Liangpunsakul, Amit G. Singal, Ju Dong Yang
Clin Mol Hepatol 2025;31(3):1058-1070. Published online April 11, 2025
Background/Aims Harmful alcohol use is a substantial contributor to liver diseases, liver cancer, and extrahepatic neoplasms. Patterns of alcohol consumption have shifted over recent decades. This study evaluates trends in alcohol-associated liver disease (ALD) and alcohol-attributable cancers in the United States (US) from 2000 to 2021.
Methods Using the methodological framework of the Global Burden of Disease Study 2021, we analyzed trends in incidence, prevalence, and mortality from ALD and alcohol-attributable cancers in the US.
Results In 2021, there were 28,340 new cases of ALD, 227,730 prevalent cases, and 21,860 deaths attributed to ALD in the US. From 2000 to 2021, ALD incidence, prevalence, and mortality increased by 43%, 36%, and 79%, respectively. The age-standardized incidence and death rate of ALD rose disproportionately among females compared to males. For alcohol-attributable cancers, primary liver cancer, colorectal cancer, and esophageal cancer accounted for the largest share of deaths in 2021. Age-standardized death rates increased significantly for primary liver cancer (annual percent change [APC] 2.21%, 95% confidence interval [CI] 1.70–2.73%) and other pharyngeal cancer (APC 1.35%, 95% CI 1.08–1.62%).
Conclusions The burden of ALD is substantial and continues to rise in the US, with a particularly notable increase among females. Mortality from alcohol-attributable cancers is also increasing, mainly driven by primary liver cancer and pharyngeal cancer. However, system-wise, gastrointestinal cancer had the highest death attributable to alcohol. These findings highlight the urgent need for public health strategies to tackle ALD, primary liver cancer, and alcoholattributable extrahepatic malignancies.
Citations
Citations to this article as recorded by
Advancing policy and practice in alcohol-associated liver disease and alcohol-attributable cancer: Correspondence to the editorial on “Sex disparities in alcohol-associated liver disease and subtype differences in alcohol-attributable cancers in the Unite Pojsakorn Danpanichkul, Donghee Kim, Karn Wijarnpreecha, Amit G. Singal, Ju Dong Yang Clinical and Molecular Hepatology.2026; 32(1): e96. CrossRef
Rising burden of steatotic liver disease in women of childbearing age and projections to 2035 Youxin Wang, Ruiqiu Chen, Shi Yan Lee, Eunice X.X. Tan, Mark Muthiah, Zhou Yu, Margaret L.P. Teng, Jazleen Leo, Cheng Han Ng, Ashok Choudhury, Daniel Q. Huang JHEP Reports.2026; 8(1): 101646. CrossRef
Stable Nationwide Sepsis-Related Mortality Does Not Extend to Individuals with Alcohol-Associated Liver Disease Pojsakorn Danpanichkul, Kwanjit Duangsonk, Claire S. Faulkner, Supapitch Sirimangklanurak, Tulaton Sodsri, Natchaya Polpichai, Shu-Yen Chan, Yanfang Pang, Omar Y. Mousa, Donghee Kim, Suthat Liangpunsakul, Karn Wijarnpreecha Digestive Diseases and Sciences.2026; 71(6): 2165. CrossRef
Improved survival and reduced alcohol‐associated hepatitis risk with renin‐angiotensin‐aldosterone system inhibitors in alcohol‐associated liver disease Pojsakorn Danpanichkul, Yanfang Pang, Donghee Kim, Andrew F. Ibrahim, Primrose Tothanarungroj, Omar Al Ta'ani, Narathorn Kulthamrongsri, Kwanjit Duangsonk, Robert J. Wong, Daniel Q. Huang, Karn Wijarnpreecha, Mazen Noureddin, Suthat Liangpunsakul Alcohol, Clinical and Experimental Research.2026;[Epub] CrossRef
Spatiotemporal trends, demographic disparities, and predictions to 2040 in gastrointestinal cancer mortality in the United States Maolang He, Jingyi Zhang, Shangqi Wang, Kainan Xing, Yanxin Zhao, Jianzhen Chen, Xi Zhang, Yong Zheng, Shuxin Tian BMC Public Health.2026;[Epub] CrossRef
Global burden of esophageal cancer attributable to smoking and alcohol, 1990–2021, with projections to 2040: a population-based analysis of the global burden of disease study 2021 Hui Zhou, Jiao Wu, Yuan Yin Annals of Medicine.2026;[Epub] CrossRef
The global epidemiology of alcohol-associated liver disease Pojsakorn Danpanichkul, Francisco Idalsoaga, Frank Murray, Juan Pablo Arab, Luis Antonio Díaz Hepatology Communications.2026;[Epub] CrossRef
History of Alcohol‐Related Cancers and ADH1B/ALDH2 Genotypes in a Large Japanese Cohort of Male Patients With Alcohol Dependence Akira Yokoyama, Tetsuji Yokoyama Cancer Medicine.2026;[Epub] CrossRef
MetALD: new insights and unraveling therapeutic potential Yue Feng, PanShiLi Han, Tao Liu, YanHang Gao Metabolism and Target Organ Damage.2025;[Epub] CrossRef
Sex Disparity in Major Adverse Liver Outcome and Major Adverse Cardiac Event in Alcohol‐Associated Liver Disease Pojsakorn Danpanichkul, Donghee Kim, Karn Wijarnpreecha, Mark D. Muthiah, Suthat Liangpunsakul Liver International.2025;[Epub] CrossRef
Effect of varenicline on major adverse liver outcomes in alcohol‐associated liver disease: An exploratory analysis Pojsakorn Danpanichkul, Yanfang Pang, Donghee Kim, Thanathip Suenghataiphorn, Donghyun Ko, Andrew F. Ibrahim, Vitchapong Prasitsumrit, Kwanjit Duangsonk, Mazen Noureddin, Karn Wijarnpreecha, Suthat Liangpunsakul Alcohol, Clinical and Experimental Research.2025; 49(11): 2451. CrossRef
Consumo de alcohol y cirrosis en mujeres: un riesgo subestimado P. Huerta, J.P. Arab, L.A. Díaz Revista de Gastroenterología de México.2025; 90(4): 509. CrossRef
Alcohol use and cirrhosis in women: An underestimated risk P. Huerta, J.P. Arab, L.A. Díaz Revista de Gastroenterología de México (English Edition).2025; 90(4): 509. CrossRef
Etiology of cirrhosis is associated with risk of hepatic decompensation and hepatocellular carcinoma Michelle Ng, Olgert Bardhi, Krystal Lai, Eden Koo, Sruthi Yekkaluri, Kevin Bass, Guruveer Bhamra, Pojsakorn Danpanichkul, Lisa Quirk, Ju Dong Yang, Jeremy Louissaint, Thomas A. Kerr, Amit G. Singal BMC Gastroenterology.2025;[Epub] CrossRef
First
Prev
