NAFLD, alcohol-associated liver disease drives rise in liver cancer deaths worldwide


Younossi Z, et al. Abstract GS008. Presented at: International Liver Congress; June 22-26, 2022; London (hybrid meeting).

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LONDON — Non-alcoholic fatty liver disease and alcohol-associated liver disease are among the biggest contributors to the increased mortality from chronic liver disease and the burden of liver cancer, a study has found.

“Although viral hepatitis B and C and alcohol-related liver disease have historically been the drivers of the burden of chronic liver disease and liver cancer, NAFLD and non-alcoholic steatohepatitis are increasingly important” , Zobair Younossi, MD, MPH, president of the Inova Health System Center for Liver Disease, said. “The most recent meta-analysis suggests that the global prevalence of NAFLD is 29% and, in 2020, NAFLD was the second most common indication for all liver transplants in the United States”

Younossi ILC
Photo credit: EASL

Assess changes in global prevalence, incidence, mortality and morbidity [disability-adjusted life-years (DALYs)] linked to liver cancer and chronic liver disease, Younossi and colleagues analyzed data from the 2019 Global Burden of Disease Study.

According to the study results, the prevalence, incidence, mortality and DALYs of liver diseases in 2019 were 1.69 billion (liver cancer: 0.04% and chronic liver disease: 99.96% ), 2.59 million (20.7% and 79.3%), 1.95 million (24.8% and 75.3%) and 58.7 million (21.3% and 78.7%).

Zobair Younossi

From 2009 to 2019, researchers reported a 33.7% increase in the prevalence of liver cancer as well as a 22.7% increase in the prevalence of chronic liver disease. Incidence (30% and 14.8%), deaths (27.2% and 10.6%) and DALYs (21.9% and 5.1%) also increased.

In addition, the increase in liver cancer deaths worldwide [per 100,000; annual percent change (APC) = 1.33%] during this decade were driven by NAFLD (0.36 to 0.45; APC = 2.47%]alcohol-associated liver disease (0.97 to 1.17; APC = 1.91 %), HBV (2.25 to 2.48; APC = 0.21%) and HCV (1.64 to 1.83; APC = 1.12%) .

During the same period, a decline in global rates of chronic liver disease (per 100,000; APC = -0.18%) was attributed to a decrease in HBV (5.07 to 4.28; APC = – 1.83%), although HCV (4.9 to 5.11; APC=0.37%), alcohol-associated liver disease (4.67 to 4.81; APC=0.45% ) and NAFLD (1.53 to 1.74; APC = 1.33%) increased.

“NALFD is responsible for the largest increase in mortality from liver cancer and chronic liver disease,” Younossi concluded. “Despite this growing burden, awareness of NAFLD is very low. To address these growing trends and low awareness, regional and global policies and programs need to be established.

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