Global burden of nasopharyngeal carcinoma attributable to alcohol use: a 1990-2021 analysis with projections to 2040.

BACKGROUND

Nasopharyngeal carcinoma attributable to alcohol use (NPC-AU) contributes substantially to global cancer mortality and disability, yet its temporal and geographic patterns remain incompletely described.

OBJECTIVES

To assess the global, regional, and national burden of NPC-AU from 1990 to 2021 and project trends through 2040.

MATERIAL AND METHODS

Using GBD 2021 data, global, regional, and national age-standardized mortality rates (ASMR) and disability-adjusted life-years rates (ASDR) attributable to alcohol were evaluated. Trends were quantified by average annual percentage change (AAPC) and projections were generated using Bayesian age-period-cohort models.

RESULTS

From 1990 to 2021, global ASMR declined from 0.31 to 0.19 per 100,000 population (AAPC -1.66; 95% CI -1.79 to -1.52) and ASDR fell with an AAPC of -1.72 (95% CI -1.87 to -1.57). Male ASMR decreased from 0.42 to 0.27 per 100,000 (AAPC -1.60), and female ASMR from 0.21 to 0.12 per 100,000 (AAPC -2.25). High-middle SDI regions saw ASMR drop from 0.50 to 0.28 per 100,000 (AAPC -1.97), whereas low-middle SDI regions experienced an increase from 0.09 to 0.11 per 100,000 (AAPC 0.72). Regionally, East Asia's ASMR declined at an AAPC of -2.70, Southern Latin America at -3.13, and Southeast Asia increased at 1.76. Age-specific peaks in ASMR shifted from 55-59 and 65-69 years in 1990 to 65-69 and 70-74 years in 2021. Projections forecast male ASMR of 0.35 per 100,000 (95% UI 0.03-0.67) and female ASMR of 0.02 per 100,000 (95% UI 0.00-0.04) by 2040.

CONCLUSIONS AND SIGNIFICANCE

Although global ASMR and ASDR for NPC-AU declined markedly from 1990 to 2021, rising burdens in lower-SDI regions, persistent male predominance, and shifting peaks to older age groups highlight the need for targeted alcohol-control policies and age-tailored screening.