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Background <p>Liver cancer mortality is increasing in the United States, driven by evolving risk factors. While hepatitis C virus was historically the leading cause, alcohol use and metabolic-associated steatohepatitis are now major contributors.</p> Methods <p>A retrospective cohort analysis was conducted using the Global Burden of Disease 2021 database to assess liver cancer mortality by etiology from 2010–2021. Joinpoint regression identified significant shifts in mortality trends (<i>P</i> &lt; 0.05).</p> Results <p>Between 2010 and 2021, U.S. liver cancer mortality rose by 53%. Hepatitis C and alcohol use accounted for 39.7% and 29.9% of liver cancer deaths in 2021, respectively. Liver cancer deaths rose by 32.14% from 2010–2016 but slowed to 15.81% from 2016–2021 (<i>P</i> = 0.0082).</p> <p>Mortality from hepatitis C increased by 32.77% (4.84% AAGR) from 2010–2016 but slowed to 15.15% (2.86% AAGR) from 2016–2021 (<i>P</i> = 0.0195). Hepatitis B-related mortality declined from 24.72% (3.75% AAGR) in 2010–2016 to 7.12% (1.38% AAGR) in 2016–2021 (<i>P</i> = 0.0001). Alcohol-related deaths rose by 34.52% (5.07% AAGR) from 2010–2016, tapering to 20.01% (3.72% AAGR) from 2016–2021 (<i>P</i> = 0.0122). Deaths attributed to MASH increased by 26.64% (8.19% AAGR) from 2010–2013, followed by slower growth of 24.80% (2.81% AAGR) from 2013–2021 (<i>P</i> = 0.1178). Mortality from other causes rose by 25.16% (3.81% AAGR) in 2010–2016 and by 19.03% (3.55% AAGR) in 2016–2021 (<i>P</i> = 0.0059).</p> Conclusion <p>Declines in hepatitis-related mortality reflect progress in antiviral treatment. However, persistently rising alcohol- and MASH-related deaths highlight the urgent need for public health strategies targeting modifiable risk factors such as alcohol use and obesity.</p>

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Beyond hepatitis: the growing burden of alcohol and MASLD in liver cancer mortality

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年10月14日

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  • Sheilabi Seeburun,
  • Priyaranjan Kata,
  • Juliana Pava De Los Rios,
  • Tanishq Kesani,
  • Jose Iglesias

摘要

Background

Liver cancer mortality is increasing in the United States, driven by evolving risk factors. While hepatitis C virus was historically the leading cause, alcohol use and metabolic-associated steatohepatitis are now major contributors.

Methods

A retrospective cohort analysis was conducted using the Global Burden of Disease 2021 database to assess liver cancer mortality by etiology from 2010–2021. Joinpoint regression identified significant shifts in mortality trends (P < 0.05).

Results

Between 2010 and 2021, U.S. liver cancer mortality rose by 53%. Hepatitis C and alcohol use accounted for 39.7% and 29.9% of liver cancer deaths in 2021, respectively. Liver cancer deaths rose by 32.14% from 2010–2016 but slowed to 15.81% from 2016–2021 (P = 0.0082).

Mortality from hepatitis C increased by 32.77% (4.84% AAGR) from 2010–2016 but slowed to 15.15% (2.86% AAGR) from 2016–2021 (P = 0.0195). Hepatitis B-related mortality declined from 24.72% (3.75% AAGR) in 2010–2016 to 7.12% (1.38% AAGR) in 2016–2021 (P = 0.0001). Alcohol-related deaths rose by 34.52% (5.07% AAGR) from 2010–2016, tapering to 20.01% (3.72% AAGR) from 2016–2021 (P = 0.0122). Deaths attributed to MASH increased by 26.64% (8.19% AAGR) from 2010–2013, followed by slower growth of 24.80% (2.81% AAGR) from 2013–2021 (P = 0.1178). Mortality from other causes rose by 25.16% (3.81% AAGR) in 2010–2016 and by 19.03% (3.55% AAGR) in 2016–2021 (P = 0.0059).

Conclusion

Declines in hepatitis-related mortality reflect progress in antiviral treatment. However, persistently rising alcohol- and MASH-related deaths highlight the urgent need for public health strategies targeting modifiable risk factors such as alcohol use and obesity.