The Global Burden of Alcohol-associated Cirrhosis and Cancer in Young and Middle-aged Adults

Abstract

Alcohol is a substance that impacts premature mortality and morbidity.¹ The liver is invariably subjected to the impact of alcohol, which can result in cirrhosis and cancer. Alcohol also has detrimental effects that extend beyond the liver. While traditionally associated with advanced age, emerging data reported a rising burden of cancers and alcohol-associated liver disease in the young.^1-3 Thus, the primary objective was to evaluate the trend of alcohol-associated cirrhosis and cancer in young and middle-aged adults (aged 15-49) utilizing the Global Burden of Disease Study (GBD) 2019.⁴ We chose the age group less than 50 years old based on the definition of early-onset cancer and the inherent selection of the age group in the GBD database.^4-6 The detailed methods are provided in the Supplementary Appendix. Briefly, data were sourced from population-based cancer registries, vital registration systems, or verbal autopsy studies. Verbal autopsy is a well-established approach for monitoring health, providing valuable information on mortality patterns and the reasons behind deaths in areas lacking robust medical death certification processes. The researchers employed the Cause of Death Ensemble model to estimate the burden linked to cancer and cirrhosis associated with alcohol use.

Figure 1.

A, Age-standardized prevalence rates from alcohol-associated cirrhosis in 2000 and 2019 by the World Health Organization region. B, Age-standardized death rates from alcohol-associated cirrhosis in 2000 and 2019 by the World Health Organization region. C, Age-standardized death rates from alcohol-associated cancer in 2000 and 2019 by the World Health Organization region. D, Age-standardized death rates from alcohol-associated cancer in 2000 and 2019 by cancer type. ASDR, Age-standardized death rate; ASPR, age-standardized prevalence rate.