S2405 Hyperglycemia-Associated Liver Cancer: Global Disparities Across Age, Sex, and Development Levels in the 2021 GBD Study

Introduction: Hyperglycemia is a growing metabolic risk factor for liver cancer, but its burden across age, sex, and socio-demographic index (SDI) levels remains undercharacterized. This study aims to assess liver cancer mortality and disability attributable to hyperglycemia using the 2021 Global Burden of Disease (GBD) Study. Methods: GBD 2021 data were analyzed from 1990–2021 to estimate liver cancer deaths, disability-adjusted life years (DALYs), and years of life lost (YLLs) attributable to hyperglycemia. Trends were stratified by age, sex, and SDI, using Average Annual Percent Change (AAPC) with 95% confidence intervals (CIs). Results: Globally, men experienced a higher burden of liver cancer attributable to hyperglycemia compared to women, with 3.21 million vs 2.83 million DALYs, respectively. The age-adjusted DALY rate increased more rapidly in men than in women (AAPC: 2.94 vs 2.68). Similarly, men had a higher total number of deaths (133,685 vs 131,616), with mortality rates rising more steeply among men (AAPC: 3.26 vs 3.01). The YLLs burden was also greater in men (3.18 million) compared to women (2.81 million), with a faster increase observed in men (AAPC: 2.94 vs 2.67). Age-stratified analysis showed that individuals aged ≥70 years experienced the most significant rise in DALYs, mortality rates, and YLLs (AAPC: 1.95, 2.13, and 1.95, respectively), followed by the 50–69 age group (AAPC: 1.43, 1.49, and 1.43) and the 15–49 age group (AAPC: 1.37, 1.42, and 1.36). When stratified by SDI, countries in the low-middle SDI category demonstrated the fastest increases in DALY rates (AAPC: 3.87), mortality rates (AAPC: 3.95), and YLLs (AAPC: 3.86), followed by countries in the high and middle SDI categories. Conclusion: The global burden of liver cancer attributable to hyperglycemia has risen substantially over the past 3 decades, with disproportionately higher impacts among men, older adults, and populations in low-middle SDI countries. These findings highlight the urgent need for targeted public health interventions and glycemic control strategies, particularly in high-risk demographic and socio-economic groups, to mitigate the growing liver cancer burden.