| Global Epidemiology of Alcohol-Related Liver Disease, Liver Cancer, and Alcohol Use Disorder, 2000–2021 |
Pojsakorn Danpanichkul1
, Luis Antonio Díaz2,3,4,5
, Kanokphong Suparan6
, Primrose Tothanarungroj7
, Supapitch Sirimangklanurak7
, Thanida Auttapracha7
, Hanna L. Blaney8
, Banthoon Sukphutanan7,9
, Yanfang Pang6,10,11,12
, Siwanart Kongarin7
, Francisco Idalsoaga4
, Eduardo Fuentes-López13
, Lorenzo Leggio14
, Mazen Noureddin15
, Trenton M. White16,17
, Alexandre Louvet18
, Philippe Mathurin18
, Rohit Loomba2
, Patrick S. Kamath19
, Jürgen Rehm20,21,22,23,24
, Jeffrey V. Lazarus5,16,17,25
, Karn Wijarnpreecha26,27,28
, Juan Pablo Arab3,4,5,29
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1Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
2MASLD Research Center, Division of Gastroenterology and Hepatology, University of California San Diego, San Diego, California, USA
3Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
4Observatorio Multicéntrico de Enfermedades Gastrointestinales (OMEGA), Santiago, Chile
5The Global NASH Council, Washington, DC, USA
6Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
7Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
8Division of Gastroenterology and Hepatology, University of Maryland, Baltimore, Maryland, USA
9Lerdsin Hospital, Bangkok, Thailand
10Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, Guangxi, China
11National Immunological Laboratory of Traditional Chinese Medicines,Baise, Guangxi, China
12Center for Medical Laboratory Science, Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, Guangxi, China
13Departamento de Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
14Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism, Division of Intramural Clinical and Biological Research, National Institutes of Health, Baltimore, Maryland, USA
15Houston Research Institute and Houston Methodist Hospital, Houston, Texas, USA
16Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
17CUNY Graduate School of Public Health and Health Policy (CUNY SPH), New York, New York, USA
18Université Lille, CHU de Lille, Service des maladies de l'appareil digestif, Hôpital Huriez, INFINITE-U1286, Lille, France
19Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA
20Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
21Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
22Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
23Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
24Centre for Interdisciplinary Addiction Research, University of Hamburg, Hamburg, Germany
25Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
26Division of Gastroenterology and Hepatology, Department of Medicine, University of Arizona College of Medicine, Phoenix, Arizona, USA
27Department of Internal Medicine, Banner University Medical Center, Phoenix, Arizona, USA
28BIO5 Institute, University of Arizona College of Medicine-Phoenix, Phoenix, Arizona, USA
29Division of Gastroenterology, Hepatology, and Nutrition, Department of Internal Medicine, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA |
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Received: September 26, 2024 Revised: December 17, 2024 Accepted: January 3, 2025
*Pojsakorn Danpanichkul and Luis Antonio Díaz contributed equally to this work. |
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| ABSTRACT |
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Background/Aims
Alcohol represents a leading burden of disease worldwide, including alcohol use disorder (AUD) and alcohol-related liver disease (ALD). We aim to assess the global burden of AUD, ALD, and alcohol-attributable primary liver cancer between 2000–2021.
Methods
We registered the global and regional trends of AUD, ALD, and alcohol-related liver cancer using data from the Global Burden of Disease 2021 Study, the largest and most up-to-date global epidemiology database. We estimated the annual percent change (APC) and its 95% confidence interval (CI) to assess changes in age-standardized rates over time.
Results
In 2021, there were 111.12 million cases of AUD, 3.02 million cases of ALD, and 132,030 cases of alcohol-attributable primary liver cancer. Between 2000 and 2021, there was a 14.66% increase in AUD, a 38.68% increase in ALD, and a 94.12% increase in alcohol-attributable primary liver cancer prevalence. While the age-standardized prevalence rate for liver cancer from alcohol increased (APC: 0.59%, 95% confidence interval [CI] 0.52 to 0.67%) over these years, it decreased for ALD (APC: -0.71%, 95% CI -0.75 to -0.67%) and AUD (APC: -0.90%, 95% CI -0.94 to -0.86%). There was significant variation by region, socioeconomic development level, and sex. During the last years (2019–2021), the prevalence, incidence, and death of ALD increased to a greater extent in females.
Conclusions
Given the high burden of AUD, ALD, and alcohol-attributable primary liver cancer, urgent measures are needed to prevent them at both global and national levels. |
| KeyWords:
alcoholic cirrhosis; liver disease; cirrhosis; alcohol-associated liver disease; ALD; AUD; epidemiology; global health; addiction; public health |
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