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Cited by 553Alcohol Consumption and Health EffectsSubstance Abuse Treatment and OutcomesHepatocellular Carcinoma Treatment and Prognosis

Global epidemiology of alcohol-associated cirrhosis and HCC: trends, projections and risk factors

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Huang, Daniel Q., Mathurin, Philippe, Cortez-Pinto, Helena, Loomba, Rohit·2023·Nature Reviews Gastroenterology & Hepatology
DOI 10.1038/s41575-022-00688-6PMC PMC9579565
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Abstract

Heavy alcohol consumption is a major cause of morbidity and mortality. Globally, alcohol per-capita consumption rose from 5.5 litres in 2005 to 6.4 litres in 2016 and is projected to increase further to 7.6 litres in 2030. In 2019, an estimated 25% of global cirrhosis deaths were associated with alcohol. The global estimated age-standardized death rate (ASDR) of alcohol-associated cirrhosis was 4.5 per 100,000 population, with the highest and lowest ASDR in Africa and the Western Pacific, respectively. The annual incidence of hepatocellular carcinoma (HCC) among patients with alcohol-associated cirrhosis ranged from 0.9% to 5.6%. Alcohol was associated with approximately one-fifth of global HCC-related deaths in 2019. Between 2012 and 2017, the global estimated ASDR for alcohol-associated cirrhosis declined, but the ASDR for alcohol-associated liver cancer increased. Measures are required to curb heavy alcohol consumption to reduce the burden of alcohol-associated cirrhosis and HCC. Degree of alcohol intake, sex, older age, obesity, type 2 diabetes mellitus, gut microbial dysbiosis and genetic variants are key factors in the development of alcohol-associated cirrhosis and HCC. In this Review, we discuss the global epidemiology, projections and risk factors for alcohol-associated cirrhosis and HCC. Global alcohol consumption has increased in the past two decades and is projected to increase further. In this Review, Loomba and colleagues discuss the global epidemiology of alcohol-associated cirrhosis and hepatocellular carcinoma, including risk factors, trends and projections.

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  • The non-viral subgroups probably consist of different proportions of HCCs due to each etiology across different trials.

    “the “non-viral” subgroups probably consist of different proportions of HCCs due to each etiology across different trials, as the above example has shown [63–65]”

    From Etiology-Based Treatment for Unresectable/Advanced Hepatocellular Carcinoma: Focus on Viral Hepatitis and Metabolic Dysfunction-Associated Steatohepatitis (2025) · cites this paper as [63]

    In ‘Gaps in the care of patients with alcohol-associated HCC’ (page unavailable), the review says that a non-viral HCC subgroup included both NAFLD-related and alcohol-associated cases, which were grouped together in the analysis. It does not say that the proportions of those etiologies differed across trials. (LLM, conf=0.83)

    Experimental — accuracy not yet measured

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Authors
Huang, D. Q., Mathurin, P., Cortez-Pinto, H., & Loomba, R.
Affiliations
  • National University of Singapore (SG)
  • Inserm (FR)
  • University of California San Diego (US)
Corresponding author
Loomba, Rohit
ORCID
Venue
Nature Reviews Gastroenterology & Hepatology
Publisher
Springer Science and Business Media LLC
Published
2022-10-18
Volume
20
Issue
1
Pages
37-49
ISSN
  • 1759-5045 (ISSN-L)
  • 1759-5053
DOI
10.1038/s41575-022-00688-6
PMC
PMC9579565
OpenAlex
W4306734898
Cited by
553
References
17
Citations by year
2026: 114 · 2025: 180 · 2024: 173 · 2023: 84 · 2022: 2
FWCI
18.34
Type
journal article
Language
en
Open access
Licence
Locations
  • Nature Reviews Gastroenterology & Hepatology (publishedVersion, cc-by)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • eScholarship (California Digital Library) (submittedVersion, cc-by)
  • HAL (submittedVersion)
  • Portuguese National Funding Agency for Science, Research and Technology (RCAAP Project by FCT) (submittedVersion)
Funders
  • U.S. Department of Defense
  • National Institutes of Health (UL1TR001442)
  • Medical Research Council
  • National Medical Research Council
  • Fundação para a Ciência e a Tecnologia
  • National Institute on Alcohol Abuse and Alcoholism (U01AA029019)
  • National Heart, Lung, and Blood Institute (P01HL147835)
  • National Institute of Diabetes and Digestive and Kidney Diseases (R01DK124318, R01DK121378, R01DK106419, P30DK120515, U01DK061734, U01DK130190)
  • National Institute of Environmental Health Sciences (P42ES010337)
  • National Center for Advancing Translational Sciences
  • DOD Peer Reviewed Cancer Research Program
Topics
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Health Sciences › Medicine › Hepatology › Hepatocellular Carcinoma Treatment and Prognosis
Keywords
alcoholic cirrhosis, hepatocellular carcinoma, alcohol consumption trends, alcohol-related liver cancer, global burden of disease, age-standardized mortality rates, risk factors, gut dysbiosis, type 2 diabetes, obesity, genetic variants
MeSH terms
Ethanol, Diabetes Mellitus, Type 2, Carcinoma, Hepatocellular, Humans, Liver Cirrhosis, Liver Cirrhosis, Alcoholic, Liver Neoplasms, Risk Factors, Incidence

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

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