Alcohol Related Liver Cancer Deaths Rising Since the Pandemic

New global research has found that deaths from alcohol related liver cancer are climbing again after years of decline. The reversal began almost exactly when the world went into lockdown. The finding sets the disease apart from other alcohol attributable conditions, most of which kept falling even as the pandemic disrupted health systems worldwide.

The analysis was published in the journal npj Science of Food, led by researchers Li, Jin and Tay. It drew on Global Burden of Disease 2023 data covering 204 countries and territories from 1990 through 2023. The result is one of the most detailed pictures yet of how these four drinking related causes of death have moved over more than three decades, and how sharply that picture changed once Covid arrived.

Three of the four conditions the researchers tracked improved steadily across the study period. Global mortality from cirrhosis fell by an estimated 1.20 percent a year. Alcoholic cardiomyopathy fell by 2.38 percent, and alcohol use disorders by 1.79 percent. Alcohol related liver cancer told a different story. Its global rate edged up from 0.95 to 1.03 deaths per 100,000 people between 1990 and 2023. That is a modest overall rise, but researchers say it conceals a much sharper shift in more recent years.

The shift was not uniform between men and women either. Across the full study period, female mortality from the disease actually declined slightly. Male rates stayed broadly flat, with a slight upward tilt, hinting at diverging risk patterns worth watching closely.

When the Trend Turned

Before 2020, the trend was heading in the right direction. Deaths were falling by around 0.74 percent a year between 2016 and 2019. Then came the pandemic. Between 2020 and 2023, that decline flipped into a rise of 1.73 percent annually worldwide, a reversal sharp enough for the researchers to flag as a distinct turning point.

Women bore the brunt of the change. Mortality from alcohol linked liver cancer climbed by 2.73 percent a year among women during this period. Among men, the rise was smaller, at 1.47 percent, but still marked a clear break from the earlier trend.

The study’s authors point to a few likely contributors. Disrupted cancer screening is one. Delayed diagnosis and treatment is another. Altered drinking habits during lockdowns may also have played a part. Several countries reported a shift toward solitary, home based drinking once pubs, bars and social venues closed their doors. Yet the authors added an important caveat. Because liver cancer typically develops over decades, they consider it biologically implausible that a few years of changed drinking alone could explain mortality shifts already visible by 2023. Disruption to healthcare systems, they suggest, is far more likely to be doing the heavy lifting.

A Global Picture With Local Extremes

Taken together, the four conditions were linked to 637,780 deaths worldwide in 2023 alone. Cirrhosis accounted for the largest share, at 308,829 deaths. Alcohol use disorders followed at 171,585, then liver cancer linked to drinking at 95,054, and alcoholic cardiomyopathy at 62,312.

The burden was far from evenly spread. Mongolia recorded the world’s highest rate of liver cancer deaths tied to drinking, at 20.60 per 100,000. It also topped the table for alcohol use disorders. Turkmenistan logged the highest cirrhosis mortality, and Latvia the highest rate of alcoholic cardiomyopathy. Such wide gaps between countries underline how strongly local drinking patterns, healthcare access and screening infrastructure shape outcomes, even when the underlying cause is the same.

Projections Through 2050

Using Bayesian age period cohort modelling, the study’s authors project that global alcohol linked liver cancer mortality will keep climbing through 2050. The estimate reaches 3.02 deaths per 100,000 among men and 0.98 among women. Men are expected to remain at higher absolute risk. Yet the relative increase projected for women is larger, a detail the researchers flagged as a widening vulnerability worth close attention. Mortality from the other three conditions, by contrast, is projected to hold steady or keep declining.

The authors stressed that these projections are indicative scenarios built on current trends, not firm predictions. The study’s design is based on modelled population estimates rather than individual patient records, so it cannot establish direct cause and effect.

The study’s authors call for disease specific surveillance and stronger cancer screening pathways. They also want interventions that address alcohol related harm and the different vulnerabilities faced by men and women. Liver cancer risk accumulates over decades of exposure, so the case for catching risky drinking early, long before disease takes hold, only grows stronger.

A downward trend, once reversed, is far harder to turn back around than it is to protect in the first place. The years since 2020 offer a stark reminder of how quickly gains built up over three decades can begin to unwind. They also show how much is riding on catching problem drinking before it ever reaches the liver.

Source: dbrecoveryresources