The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, 322000, Zhejiang, China.
The Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310000, Zhejiang Province, China.
Hepatol Int. 2023 Aug;17(4):1028-1044. doi: 10.1007/s12072-023-10503-2. Epub 2023 Mar 5.
Identifying the temporal trends of cirrhosis and liver cancer attributable to alcohol use in both the past and the future can formulate the control strategies.
Data on cirrhosis and liver cancer attributable to alcohol use from 1990 to 2019, including mortality and disability-adjusted life year (DALY) rates were collected from the 2019 Global Burden of Disease (GBD) study. To analyze the temporal trends, the average annual percentage change (AAPC) was calculated, and the Bayesian age-period-cohort model was applied.
Deaths and DALY of cirrhosis and liver cancer attributable to alcohol use increased year by years, but the age-standardized death rate (ASDR) and age-standardized DALY rate declined or remained stable from 1990 to 2019 in most regions of the world. The burden of cirrhosis attributable to alcohol increased in low-middle social-development index (SDI) regions, while the burden of liver cancer increased in high-SDI regions. Eastern Europe and Central Asia have the highest burden of cirrhosis and liver cancer caused by alcohol use. Deaths and DALYs are mainly distributed in people aged 40+ years, but there is an increasing trend in people aged under 40 years. New deaths from cirrhosis and liver cancer attributable to alcohol use are predicted to increase in the next 25 years, but the ASDR of cirrhosis in males will increase slightly.
Although the age-standardized rate of cirrhosis and liver cancer due to alcohol use have decreased, the absolute burden increased and will continue to increase. Therefore, alcohol control measures should be further strengthened and improved through effective national policies.
识别过去和未来因饮酒导致的肝硬化和肝癌的时间趋势，有助于制定控制策略。
从 2019 年全球疾病负担（GBD）研究中收集了 1990 年至 2019 年因饮酒导致的肝硬化和肝癌的死亡率和伤残调整生命年（DALY）数据。为了分析时间趋势，计算了平均年变化百分比（AAPC），并应用了贝叶斯年龄-时期-队列模型。
因饮酒导致的肝硬化和肝癌的死亡人数和 DALY 逐年增加，但在世界大多数地区，1990 年至 2019 年，年龄标准化死亡率（ASDR）和年龄标准化 DALY 率下降或保持稳定。低-中社会发展指数（SDI）地区的酒精性肝硬化负担增加，而高 SDI 地区的肝癌负担增加。东欧和中亚地区因酒精使用导致的肝硬化和肝癌负担最重。死亡和 DALY 主要分布在 40 岁以上人群，但 40 岁以下人群的死亡人数呈上升趋势。预计未来 25 年内，因酒精使用导致的肝硬化和肝癌的新死亡人数将增加，但男性肝硬化的 ASDR 将略有增加。
尽管因饮酒导致的肝硬化和肝癌的年龄标准化率有所下降，但绝对负担增加且将继续增加。因此，应通过有效的国家政策，进一步加强和完善酒精控制措施。
