Global trends in liver cancer attributable to drug use: A Global Burden of Disease 2021 analysis (1980–2021).

231 Background: Being the seventh most common cancer in the world and second leading cause of cancer related causalities, Hepatocellular carcinoma (HCC) or liver cancer is a malignant disease with a very poor prognosis. It is unfortunate that patients are often diagnosed at advanced stages and the incidence rates of liver cancer are influenced by numerous risk factors. Drug usage is one of the emerging pieces of evidence, particularly injectable drugs as they pose a risk for the transmission of Hepatitis B and C. However. consumption of illegal or conventional drugs may be a potential cause of the development of cirrhosis. We present a comprehensive analysis derived from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 portraying drug usage and liver cancer associated mortality from 1980 to 2021. Methods: Global Burden of Diseases (GBD) study was used to retrieve data methodically, it included age-standardized death rates, Years of Lost Life (YLL), and disability-adjusted life years (DALYs). It was stratified globally and categorized by continent, with the USA divided into its states, and by socio-demographic index. The average annual percentage changes (AAPC) were determined using Joinpoint Regression. Results: The age-standardized death rates (ASDR) for liver cancer globally had an overall rise from 1980 to 2021. The ASDR for 1980 was 0.41 (95% UI; 0.29-0.57), and it increased to 0.76 (AAPC: 1.96; 95% CI; 1.77 to 2.16) in 2021. Globally, the disability-adjusted life-years (DALYs) rate was 12.07 (95% UI: 8.68 to 16.13) per 100,000 people in 1990, and it rose to 18.39 (AAPC: 1.36; 95% CI: 1.22 to 1.51) in 2021. The age-standardized years of life lost (YLL) showed a steady rise from 1980 to 2021 with an AAPC of 1.35 (95% CI: 1.21 to 1.50). In the continental analysis, America showed increasing trends (AAPC = 3.35; 95% CI 3.02 to 3.68), followed by Europe and Africa (AAPC = 2.86; 95% CI 2.52 to 3.21) and (AAPC = 2.84; 95% CI 2.64 to 3.04), respectively. Moreover, these continents had the sharpest rise, while Asia had a slower rise in trends (AAPC = 1.31; 95% CI 1.07 to 1.56). However, upon state-wise analysis of the USA, California reported the highest mortality rates with an average ASDR of 1.70, followed by the District of Colombia with an average ASDR of 1.65, and Tennessee, which had an average ASDR of 1.30, respectively. According to the socio-demographic index (SDI), a rising trend in death rates was seen across each region, with high, low, and low-middle regions showing the sharpest rise. Conclusions: This study revealed a global peak in the liver cancer fatality rates from 1980 to 2021. Although there has been noteworthy progress globally and in America, the mortality rates have peaked overall and in the USA, especially in California, which exhibited the highest rates. An increase in death rates is also observed in low- and lower-middle-income states that corresponds to an overall rise globally.