Background <p>Alcohol consumption is a well-established risk factor for multiple cancer types, yet its contribution to the global cancer burden remains insufficiently quantified. This study systematically assesses the global, regional, and national burden of alcohol-attributable cancers (AAC) from 1990 to 2021.</p> Methods <p>AAC mortality and disability-adjusted life-years (DALYs), as well as corresponding age-standardized rates, were extracted from the Global Burden of Disease (GBD) 2021 database. Temporal trends were evaluated using Joinpoint regression, and future burden was projected with a Bayesian age-period-cohort (BAPC) model. Decomposition analysis quantified the contributions of population growth, aging, and epidemiological changes, while frontier analysis evaluated the efficiency of AAC control across countries.</p> Results <p>Between 1990 and 2021, global AAC deaths increased from 195,525 to 343,370, despite a decline in the age-standardized deaths rate (ASDR) from 4.87 to 3.97 per 100,000 (AAPC: −0.67%; 95% CI −0.79 to −0.55). Similar trends were observed for DALYs, with a 23% reduction in the age-standardized DALYs rate. Socioeconomic disparities persisted, with high-SDI regions experiencing a decline in ASDR despite rising absolute deaths, while low-SDI regions exhibited minimal change. Regionally, East Asia exhibited the highest AAC burden, whereas high-income North America had the lowest burden but showed a slight increase in ASDR. Liver, esophageal, and colorectal cancers accounted for the largest AAC burden. Decomposition analysis identified population aging and growth as primary contributors to increasing AAC burden, while frontier analysis highlighted disparities in AAC control, with Mongolia exhibiting the highest prevention gap. Projections suggest a continued decline in ASDR, while the absolute AAC burden is expected to rise.</p> Conclusions <p>Although the ASDR of AAC has declined globally and is expected to further decrease over the next 25&#xa0;years, the absolute burden of AAC continues to grow. Hence, enhancing and refining global alcohol control policies is necessary to alleviate the global burden of AAC.</p>

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The global burden of alcohol-attributable cancers from 1990 to 2021: assessment and projection based on the global burden of disease study 2021

  • Zhiqi Hu,
  • Zheng Gong,
  • Ze Zhang,
  • Yichen Wang,
  • Ying Huang,
  • Hongbo Huang,
  • Tingting Wei,
  • Jiaying Li,
  • Aijie Zhang,
  • Yunhai Li,
  • Fan Li

摘要

Background

Alcohol consumption is a well-established risk factor for multiple cancer types, yet its contribution to the global cancer burden remains insufficiently quantified. This study systematically assesses the global, regional, and national burden of alcohol-attributable cancers (AAC) from 1990 to 2021.

Methods

AAC mortality and disability-adjusted life-years (DALYs), as well as corresponding age-standardized rates, were extracted from the Global Burden of Disease (GBD) 2021 database. Temporal trends were evaluated using Joinpoint regression, and future burden was projected with a Bayesian age-period-cohort (BAPC) model. Decomposition analysis quantified the contributions of population growth, aging, and epidemiological changes, while frontier analysis evaluated the efficiency of AAC control across countries.

Results

Between 1990 and 2021, global AAC deaths increased from 195,525 to 343,370, despite a decline in the age-standardized deaths rate (ASDR) from 4.87 to 3.97 per 100,000 (AAPC: −0.67%; 95% CI −0.79 to −0.55). Similar trends were observed for DALYs, with a 23% reduction in the age-standardized DALYs rate. Socioeconomic disparities persisted, with high-SDI regions experiencing a decline in ASDR despite rising absolute deaths, while low-SDI regions exhibited minimal change. Regionally, East Asia exhibited the highest AAC burden, whereas high-income North America had the lowest burden but showed a slight increase in ASDR. Liver, esophageal, and colorectal cancers accounted for the largest AAC burden. Decomposition analysis identified population aging and growth as primary contributors to increasing AAC burden, while frontier analysis highlighted disparities in AAC control, with Mongolia exhibiting the highest prevention gap. Projections suggest a continued decline in ASDR, while the absolute AAC burden is expected to rise.

Conclusions

Although the ASDR of AAC has declined globally and is expected to further decrease over the next 25 years, the absolute burden of AAC continues to grow. Hence, enhancing and refining global alcohol control policies is necessary to alleviate the global burden of AAC.