S2894 Global Trends in Alcohol-Related Liver Cancer From 1980 to 2021: An Analysis of the GBD 2021 Study

Introduction: Hepatocellular carcinoma or liver cancer, as it is commonly referred to, is the sixth most common cancer in the world. Among the various risk factors alcohol is the most important one as it is classified as Group 1 carcinogen by the International Agency for Research. Excessive alcohol intake results in fatty liver, acute and chronic hepatitis and ultimately cirrhosis of the liver. It is reported that alcohol abuse chronically and irreversibly damages the liver and increases the risk of hepatocellular carcinoma by 3- to 10- fold. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 evaluated the mortality rate of liver cancer associated with alcohol use from 1980 to 2021. Methods: The Global Burden of Diseases (GBD) study was used to retrieve data which included age- standardized death rates, Years of Lost Life (YLL), and disability-adjusted life years (DALYs). It was further stratified globally and organized into continents, with USA stratified into its states, and by socio-demographic index. The average annual percentage changes (AAPC) were ascertained using Joinpoint Regression. Results: From 1980 to 2021, globally the Age standardized death rates (ASDR) for liver cancer showed an overall rise. The ASDR in 1980 was 0.99 (95% UI: 0.82-1.19) and in 2021 it increased to 1.08 (AAPC: 0.30; 95% CI: 0.16 to 0.44). Globally, the disability-adjusted life-years (DALYs) rate was 26.43 (95% UI: 21.57-32.28) in 1980 and it increased to 27.20 (AAPC: 0.11; 95% CI: -0.03 to 0.25) in 2021. From 1990 to 2021, the age-standardized years of life lost (YLL) demonstrated a uniform rise with an AAPC of 0.10 (95% CI: -0.04 to 0.25). However, upon continent wise analysis, Africa and Europe have the highest mortality rate but Africa has decreasing trends (AAPC = -0.27 95% CI: -0.37 to -0. 18) whereas Europe has a rise in trends (AAPC = 0.77 95% CI: 0.54 to 0.99). From 1980 to 2021, the AAPC for America was 1.72 (95% CI: 1.38 to 2.06) with a rising trend. Similarly, Asia portrayed a slight declining trend with an AAPC of -0.03 (95% CI: -0.23 to 0.17). Upon further analysis of USA, the top 3 states with the highest mortality rates include the District of Colombia with an average ASDR of 1.67 followed by Texas that showed an average ASDR of 1.63 and Hawaii with an ASDR of 1.41. Conclusion: The study reveals a global rise in liver cancer fatality rates from 1980 to 2021. Even though substantial efforts have been made in Europe and Africa, the death rates have still risen in America and Asia.