NAFLD, Alcohol-Related Liver Disease Leads to Rise in Global Liver Cancer Deaths


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

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LONDON — Non-alcoholic fatty liver and alcohol-related liver disease are among the leading causes of increased mortality associated with chronic liver disease and liver cancer, according to research.

“While viral hepatitis B and C and alcohol liver disease have historically been the cause of chronic liver disease and liver cancer, NAFLD and nonalcoholic steatohepatitis have become increasingly prominent,” Zobair younossia 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 by 2020, NAFLD was the second indication for all liver transplants in the US”

Younossi ILC
Photo credit: EASL

To assess changes in 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 research results, the prevalence, incidence, mortality and DALYs of 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%).

Zobair Younossi

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

Continued rise in liver cancer deaths worldwide [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-related 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%).

Over the same period, a decrease in the global rate 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-related 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,” concluded Younossi. “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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