Global burden of liver cancer mortality due to alcohol use from 1990 to 2021 and predictions to 2050

Abstract

Aim: This study aimed to explore the long-term mortality trends in the mortality burden of liver cancer due to alcohol use (LCA) from 1990 to 2021 and assess health inequalities stratified by sex and location, with projections to 2050. The contribution of population growth, age structure and epidemiologic changes to the increase in deaths will also be assessed.

Methods: Bayesian age-period-cohort model was applied to predict age-standardized mortality rate (ASMR). Bayesian spatiotemporal model was utilized to characterize the spatiotemporal distribution of ASMR. Frontier analysis assessed national prevention and control capacity. Decomposition analysis was performed to clarify driving factors of mortality growth.

Results: Global LCA ASMR presented an upward trend during 1990-2021 (AAPC = 0.35). Europe yielded the highest ASMR at 1.34, followed by Africa, while the Americas witnessed the fastest growth. National-level ASMR displayed obvious spatial clustering, with hotspots concentrated in West Africa, Southern Africa and partial Southeast Asian territories. Global LCA ASMR is projected to decline after 2022 and reach 0.93 by 2050. The Americas will undergo an initial rise followed by a subsequent drop in ASMR. Population aging will serve as the predominant driver of growing LCA mortality worldwide. Several nations including Brazil and Somalia are expected to attain relatively low ASMR by 2050.

Conclusion: LCA-related ASMR and health inequalities have aggravated across regions and countries. Targeted regional public health interventions are urgently required, particularly in the Americas and Africa.

Keywords

Liver cancer / alcohol use / age-standardized mortality rates / average annual percent change / Bayesian age-period-cohort model

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