Clinical and Molecular Hepatology

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Hepatic neoplasm

The current trends in the health burden of primary liver cancer across the globe: Peter Konyn, Aijaz Ahmed, Donghee Kim; Clin Mol Hepatol 2023;29(2):358-362.
Published online March 14, 2023; DOI: https://doi.org/10.3350/cmh.2023.0092

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Hepatic neoplasm

The latest global burden of liver cancer: A past and present threat: Joo Hyun Oh, Dae Won Jun; Clin Mol Hepatol 2023;29(2):355-357.
Published online March 9, 2023; DOI: https://doi.org/10.3350/cmh.2023.0070

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Original Article

Hepatic neoplasm

Global burden of primary liver cancer and its association with underlying aetiologies, sociodemographic status, and sex differences from 1990–2019: A DALY-based analysis of the Global Burden of Disease 2019 study: Sungchul Choi, Beom Kyung Kim, Dong Keon Yon, Seung Won Lee, Han Gyeol Lee, Ho Hyeok Chang, Seoyeon Park, Ai Koyanagi, Louis Jacob, Elena Dragioti, Joaquim Radua, Jae Il Shin, Seung Up Kim, Lee Smith; Clin Mol Hepatol 2023;29(2):433-452.
Published online January 4, 2023; DOI: https://doi.org/10.3350/cmh.2022.0316

Background/Aims
Global distribution of dominant liver cancer aetiologies has significantly changed over the past decades. This study analyzed the updated temporal trends of liver cancer aetiologies and sociodemographic status in 204 countries and territories from 1990 to 2019.
Methods
The Global Burden of Disease 2019 report was used for statistical analysis. In addition, we performed stratification analysis to five quintiles using sociodemographic index and 21 geographic regions.
Results
The crude numbers of liver cancer disease-adjusted life years (DALYs) and deaths significantly increased during the study period (DALYs; 11,278,630 in 1990 and 12,528,422 in 2019, deaths; 365,215 in 1990 and 484,577 in 2019). However, the Age-standardized DALY and mortality rates decreased. Hepatitis B virus (HBV) remains the leading cause of liver cancer DALYs and mortality, followed by hepatitis C virus (HCV), alcohol consumption, and non-alcoholic steatohepatitis/non-alcoholic fatty liver disease (NASH/NAFLD). Although Age-standardized DALY and mortality rates of liver cancer due to HBV and HCV have decreased, the rates due to alcohol consumption and NASH/NAFLD have increased. In 2019, the population of the East Asia region had the highest Age-standardized DALY and mortality rates, followed by high-income Asia-Pacific and Central Asia populations. Although East Asia and high-income Asia-Pacific regions showed a decrease during the study period, Age-standardized DALY rates increased in Central Asia. High-income North American and Australasian populations also showed a significant increase in Age-standardized DALY.
Conclusions
Liver cancer remains an ongoing global threat. The burden of liver cancer associated with alcohol consumption and NASH/NAFLD is markedly increasing and projected to continuously increase.

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Special topic: Alcoholic liver diseases
The 14th International Symposium on Alcoholic Liver and Pancreatic Diseases and Cirrhosis (ISALPDC)

Alcohol-related liver disease

Global and regional impacts of alcohol use on public health: Emphasis on alcohol policies: Seung Ha Park, Dong Joon Kim; Clin Mol Hepatol 2020;26(4):652-661.
Published online October 1, 2020; DOI: https://doi.org/10.3350/cmh.2020.0160

Abstract
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Alcohol is a well-known risk factor for premature morbidity and mortality. The per capita alcohol consumption of the world’s population rose from 5.5 L in 2005 to 6.4 L in 2010 and was still at the level of 6.4 L in 2016. Alcohol-attributable deaths and disability-adjusted life years (DALYs) declined from 2000 to 2016 by 17.9% and 14.5%, respectively. However, these gains observed in the alcohol-attributable burden have proportionally not kept pace with the total health gains during the same period. In 2016, 3.0 million deaths worldwide and 132 million DALYs were attributable to alcohol, responsible for 5.3% of all deaths and 5.0% of all DALYs. These burdens are the highest in the regions of Eastern Europe and sub-Saharan Africa. The alcohol-attributable burden is particularly heavy among young adults, accounting for 7.2% of all premature mortalities. Among the disease categories to which alcohol is related, injuries, digestive diseases, and cardiovascular diseases are the leading causes of the alcohol-attributable burden. To reduce the harmful use of alcohol in a country, the ‘whole of government’ and ‘whole of society’ approaches are required with the implementation of evidence-based alcohol control policies, the pursuit of public health priorities, and the adoption of appropriate policies over a long period of time. In this review, we summarize previous efforts to investigate the alcohol-attributable disease burden and the best ways to protect against harmful use of alcohol and promote health.

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