NAFLD, alcohol-associated liver disease spur rise in global liver cancer deaths
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LONDON — Nonalcoholic fatty liver disease and alcohol-associated liver disease are among the main contributors of increased mortality related to chronic liver disease and liver cancer burden, according to research.
“Although viral hepatitis B and C and alcohol liver disease have historically been the drivers of burden of chronic liver disease and liver cancer, NAFLD and nonalcoholic steatohepatitis have increasingly become more prominent,” Zobair Younossi, MD, MPH, president of Inova Health System Center for Liver Diseases, said. “The most recent meta-analysis suggests that the global prevalence of NAFLD is 29%, and in 2020 NAFLD was the second indication for all liver transplants in the U.S.”
To assess changes in the global prevalence, incidence, mortality and morbidity [disability-adjusted life-years (DALYs)] related to liver cancer and chronic liver disease, Younossi and colleagues analyzed data from the 2019 Global Burden of Disease Study.
According to study results, the prevalence, incidence, mortality and DALYs from liver disease in 2019 was 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%).
From 2009 to 2019, researchers reported a 33.7% increase in liver cancer prevalence as well as a 22.7% increase in chronic liver disease prevalence. Incidence (30% and 14.8%), deaths (27.2% and 10.6%) and DALYs (21.9% and 5.1%) also increased.
Further, increases in global liver cancer deaths [per 100,000; annual percent change (APC) = 1.33%] during that 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%) .
In the same time period, a drop in global chronic liver disease rates (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 greatest increase in mortality related to liver cancer and chronic liver disease,” Younossi concluded. “Despite this increasing burden, awareness about NAFLD is very low. To address these increasing trends and low awareness, regional and global policies and programs need to be established.”
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Younossi Z, et al. Abstract GS008. Presented at: International Liver Congress; June 22-26, 2022; London (hybrid meeting).
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