Global burden of nasopharyngeal carcinoma attributable to alcohol use: a 1990-2021 analysis with projections to 2040

Abstract

Background: Nasopharyngeal carcinoma attributable to alcohol use (NPC-AU) contributes substantially to global cancer mortality and disability, yet its temporal and geographic patterns remain incompletely described.

Objectives: To assess the global, regional, and national burden of NPC-AU from 1990 to 2021 and project trends through 2040.

Material and methods: Using GBD 2021 data, global, regional, and national age-standardized mortality rates (ASMR) and disability-adjusted life-years rates (ASDR) attributable to alcohol were evaluated. Trends were quantified by average annual percentage change (AAPC) and projections were generated using Bayesian age-period-cohort models.

Results: From 1990 to 2021, global ASMR declined from 0.31 to 0.19 per 100,000 population (AAPC -1.66; 95% CI -1.79 to -1.52) and ASDR fell with an AAPC of -1.72 (95% CI -1.87 to -1.57). Male ASMR decreased from 0.42 to 0.27 per 100,000 (AAPC -1.60), and female ASMR from 0.21 to 0.12 per 100,000 (AAPC -2.25). High-middle SDI regions saw ASMR drop from 0.50 to 0.28 per 100,000 (AAPC -1.97), whereas low-middle SDI regions experienced an increase from 0.09 to 0.11 per 100,000 (AAPC 0.72). Regionally, East Asia's ASMR declined at an AAPC of -2.70, Southern Latin America at -3.13, and Southeast Asia increased at 1.76. Age-specific peaks in ASMR shifted from 55-59 and 65-69 years in 1990 to 65-69 and 70-74 years in 2021. Projections forecast male ASMR of 0.35 per 100,000 (95% UI 0.03-0.67) and female ASMR of 0.02 per 100,000 (95% UI 0.00-0.04) by 2040.

Conclusions and significance: Although global ASMR and ASDR for NPC-AU declined markedly from 1990 to 2021, rising burdens in lower-SDI regions, persistent male predominance, and shifting peaks to older age groups highlight the need for targeted alcohol-control policies and age-tailored screening.

Keywords: alcohol-attributable burden; disability-adjusted life years; global burden; mortality; nasopharyngeal carcinoma.

Figure 1

The ASMR and ASDR of NPC-AU from 1990 to 2021 by sex and SDI region. NPC-AU, nasopharynx cancer attributable to alcohol use; ASMR, age-standardized mortality rate; ASDR, age-standardized disability-adjusted life years rate; SDI, Sociodemographic Index.

Figure 2

The AAPC of ASMR for NPC-AU at the global level, across the five SDI regions, and within 21 GBD regions, shown for the overall population (A), males (B), and females (C). NPC-AU, nasopharynx cancer attributable to alcohol use; AAPC, average annual percentage change; ASMR, age-standardized mortality rate; SDI, sociodemographic Index.

Figure 3

Global ASMR of NPC-AU in 1990 (A) and 2021 (B), AAPC (C). AAPC, average annual percentage change; ASMR, age-standardized mortality rate; NPC-AU, nasopharynx cancer attributable to alcohol use.

Figure 4

The age distribution of deaths of NPC-AU in different age groups, by sex, in 1990 (A) and 2021 (B). AAPC of global ASMR of NPC-AU in different age groups from 1990 to 2021, by sex (C) and SDI region (D). NPC-AU, nasopharynx cancer attributable to alcohol use; AAPC, average annual percentage change; ASMR, age-standardized mortality rate; SDI, sociodemographic index; CI, certainty interval.

Figure 5

Correlations between ASMR of NPC-AU and SDI at the regional level in 1990 (A) and 2021 (B), and at the national level in 1990 (C) and 2021 (D). ASMR, age-standardized mortality rate; SDI, socio-demographic Index; NPC-AU, nasopharynx cancer attributable to alcohol use.

Figure 6

The actual and predicted values in deaths of NPC-AU for the overall population, males, and females. ASR, age-standardized rate; NPC-AU, nasopharynx cancer attributable to alcohol use.