Global epidemiology of alcohol-related liver disease, liver cancer, and alcohol use disorder, 2000–2021
Open accessAbstract
Background/Aims: Alcohol represents a leading burden of disease worldwide, including alcohol use disorder (AUD) and alcohol-related liver disease (ALD). We aim to assess the global burden of AUD, ALD, and alcohol-attributable primary liver cancer between 2000–2021.Methods: We registered the global and regional trends of AUD, ALD, and alcohol-related liver cancer using data from the Global Burden of Disease 2021 Study, the largest and most up-to-date global epidemiology database. We estimated the annual percent change (APC) and its 95% confidence interval (CI) to assess changes in age-standardized rates over time.Results: In 2021, there were 111.12 million cases of AUD, 3.02 million cases of ALD, and 132,030 cases of alcohol-attributable primary liver cancer. Between 2000 and 2021, there was a 14.66% increase in AUD, a 38.68% increase in ALD, and a 94.12% increase in alcohol-attributable primary liver cancer prevalence. While the age-standardized prevalence rate for liver cancer from alcohol increased (APC 0.59%; 95% confidence interval [CI] 0.52 to 0.67%) over these years, it decreased for ALD (APC –0.71%; 95% CI –0.75 to –0.67%) and AUD (APC –0.90%; 95% CI –0.94 to –0.86%). There was significant variation by region, socioeconomic development level, and sex. During the last years (2019–2021), the prevalence, incidence, and death of ALD increased to a greater extent in females.Conclusions: Given the high burden of AUD, ALD, and alcohol-attributable primary liver cancer, urgent measures are needed to prevent them at both global and national levels.
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TL;DR
Using Global Burden of Disease 2021 data, this study reports that in 2021 there were 111.12 million AUD cases, 3.02 million ALD cases, and 132,030 alcohol-attributable primary liver cancer cases worldwide. From 2000 to 2021, case counts rose for all three conditions, while age-standardized rates declined for AUD and ALD but increased for alcohol-attributable primary liver cancer.
Key findings
- In 2021, AUD cases were 111.12 million (+14.66% from 2000), ALD cases were 3.02 million (+38.68%), and alcohol-attributable primary liver cancer cases were 132,030 (+94.12%). Deaths were 158,470 for AUD (−3.23%), 354,250 for ALD (+32.60%), and 92,230 for alcohol-attributable primary liver cancer (+76.75%).
- From 2000 to 2021, the age-standardized prevalence rate increased for alcohol-attributable primary liver cancer (APC 0.59%; 95% CI 0.52–0.67%) but decreased for ALD (APC −0.71%; 95% CI −0.75 to −0.67%) and AUD (APC −0.90%; 95% CI −0.94 to −0.86%).
- Regional and national variation was substantial: the highest AUD ASPR was in Eastern Europe (3,292.73), the highest ALD ASPR was in Eastern Europe (125.22), and the highest alcohol-attributable primary liver cancer ASPR was in Australasia (3.77). Country-level ASPRs were highest in Mongolia for AUD (4,716.94), the Republic of Moldova for ALD (182.41), and Mongolia for alcohol-attributable primary liver cancer (17.07).
- During 2019–2021, ALD prevalence, incidence, and mortality increased more in females than males: prevalence by 4.90%, incidence by 4.96%, and mortality by 1.07% in females, versus 3.87%, 3.73%, and 0.88% in males. The paper also reports 49 countries/territories with an uptrend in ALD prevalence and 111 with an uptrend in alcohol-attributable liver cancer prevalence from 2000 to 2021.
Methods
- The study used Global Burden of Disease 2021 data from 2000 to 2021, accessed through the Global Health Data Exchange, covering 204 countries and territories and stratified by sex, GBD region, and sociodemographic index (SDI).
- Estimates included prevalence, incidence, and deaths for AUD, ALD, and alcohol-attributable primary liver cancer, with age-standardized rates per 100,000 and 95% uncertainty intervals based on the 2.5th and 97.5th ranked values across 1,000 posterior draws.
- Trends were assessed using annual percent change (APC) and 95% confidence intervals via Joinpoint regression program version 4.9.1.0; increasing or decreasing trends were classified based on the APC and its confidence interval boundaries.
Limitations
- The paper states that GBD studies face limitations related to availability and quality of primary data, especially vital registration systems; GBD methodology may underestimate mortality in low-income countries due to lack of high-quality data and underreported risk factors related to alcohol stigma.
- The paper states that AUD was estimated using ICD-10 codes rather than DSM-5, which may underestimate the true burden of AUD, ALD, and alcohol-attributable liver cancer; alcohol use reporting also tends to be underestimated. It also notes that geographic and SDI strata are not fully comprehensive and that the GBD framework attributes a single cause to a specific outcome, preventing inclusion of co-variation with other risk factors.
- Evident from the text: these are model-based, ecological estimates with uncertainty intervals rather than individual-level or causal data, and the authors call for future modeling incorporating comorbidities and other determinants such as race, ethnicity, age, socioeconomic status, cultural factors, viral hepatitis, and metabolic dysfunction.
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- Findingown data
From 2000 to 2021, the age-standardized prevalence rate for ALD decreased (APC -0.71%; 95% CI -0.75 to -0.67%).
“it decreased for ALD (APC –0.71%; 95% CI –0.75 to –0.67%)”
Quote in the paperNot a substantial claim - Findingown data
From 2019 to 2021, ALD prevalence increased more in females (4.90%) than in males (3.87%).
“However, ALD metrics increased more in females: prevalence by 4.90%, incidence by 4.96%, and mortality by 1.07%. In males, prevalence increased by 3.87%, incidence by 3.73%, and mortality by 0.88% (Supplementary Fig. 1D–F).”
Quote in the paperNot a substantial claim - Findingown data
From 2000 to 2021, the age-standardized death rate for ALD declined (APC -1.11%; 95% CI -1.19 to -1.04%).
“and ALD (APC –1.11%; 95% CI –1.19 to –1.04%)”
Quote in the paperNot a substantial claim - Findingown data
From 2000 to 2021, ASDR of AUD increased only in High-income North America (APC 1.83%).
“On the other hand, ASDR increased only in High-income North America (APC 1.83%; 95% CI 1.16 to 2.50%)”
Quote in the paperNot a substantial claim - Findingown data
In 2021, there were 3.02 million cases of alcohol-related liver disease (ALD) globally.
“In 2021, there were 111.12 million cases of AUD, 3.02 million cases of ALD, and 132,030 cases of alcohol-attributable primary liver cancer.”
Quote in the paperNot a substantial claim
- Findingown data
From 2000 to 2021, the age-standardized incidence rate for ALD decreased (APC -0.84%; 95% CI -0.87 to -0.82%).
“and ALD (APC –0.84%; 95% CI –0.87 to –0.82%)”
Quote in the paperNot a substantial claim - Findingown data
There was significant variation by region, socioeconomic development level, and sex in the burden of AUD, ALD, and alcohol-attributable primary liver cancer.
“There was significant variation by region, socioeconomic development level, and sex.”
Quote in the paperSubstantial claim - Findingown data
From 2000 to 2021, the age-standardized incidence rate for AUD decreased (APC -0.78%; 95% CI -0.81 to -0.75%).
“yet decreased in AUD (APC –0.78%; 95% CI –0.81 to –0.75%)”
Quote in the paperNot a substantial claim - Findingown data
From 2019 to 2021, AUD prevalence decreased in females.
“From 2019 to 2021, AUD prevalence and incidence increased in males, whereas it decreased in females (Supplementary Fig. 1D–E).”
Quote in the paperNot a substantial claim - Findingown data
From 2019 to 2021, AUD incidence increased in males.
“From 2019 to 2021, AUD prevalence and incidence increased in males, whereas it decreased in females (Supplementary Fig. 1D–E).”
Quote in the paperNot a substantial claim - Findingown data
Between 2000 and 2021, alcohol-attributable primary liver cancer prevalence increased by 94.12% globally.
“Between 2000 and 2021, there was a 14.66% increase in AUD, a 38.68% increase in ALD, and a 94.12% increase in alcohol-attributable primary liver cancer prevalence.”
Quote in the paperNot a substantial claim - Findingown data
From 2019 to 2021, AUD death decreased at a higher degree in females than males.
“AUD death decreased at a higher degree in females than males (Supplementary Fig. 1F).”
Quote in the paperNot a substantial claim - Findingown data
From 2000 to 2021, the age-standardized prevalence rate for alcohol-attributable primary liver cancer increased (APC 0.59%; 95% CI 0.52 to 0.67%).
“While the age-standardized prevalence rate for liver cancer from alcohol increased (APC 0.59%; 95% confidence interval [CI] 0.52 to 0.67%) over these years”
- Also stated in: § The global burden of alcohol use disorder, alcohol-related liver disease, and alcohol-attributable primary liver cancer · hedged
“An examination of trends from 2000 to 2021 indicated an annual rise in the ASPR for alcohol-attributable primary liver cancer (APC: 0.59%, 95% CI 0.52 to 0.67%)”
Quote in the paperNot a substantial claim - Also stated in: § The global burden of alcohol use disorder, alcohol-related liver disease, and alcohol-attributable primary liver cancer · hedged
- Findingown data
During 2019-2021 versus 2000-2019, prevalence, incidence, and mortality (except for AUD) underwent nearly equal or higher degrees of changes in the pre-pandemic compared to the pandemic timeframe.
“When analyzed during the pandemic timeframe (2019 to 2021) versus the pre-pandemic timeframe (2000 to 2019), prevalence, incidence, and mortality (except for AUD) underwent nearly equal or higher degrees of changes in the pre-pandemic compared to the pandemic timeframe (Supplementary Fig. 1A–F).”
Quote in the paperNot a substantial claim - Findingown data
From 2019 to 2021, ALD incidence increased more in females (4.96%) than in males (3.73%).
“However, ALD metrics increased more in females: prevalence by 4.90%, incidence by 4.96%, and mortality by 1.07%. In males, prevalence increased by 3.87%, incidence by 3.73%, and mortality by 0.88% (Supplementary Fig. 1D–F).”
Quote in the paperNot a substantial claim - Findingown data
From 2000 to 2021, the age-standardized prevalence rate for AUD decreased (APC -0.90%; 95% CI -0.94 to -0.86%).
“and AUD (APC –0.90%; 95% CI –0.94 to –0.86%)”
Quote in the paperNot a substantial claim - Findingown data
From 2019 to 2021, AUD incidence decreased in females.
“From 2019 to 2021, AUD prevalence and incidence increased in males, whereas it decreased in females (Supplementary Fig. 1D–E).”
Quote in the paperNot a substantial claim - Findingown data
Between 2000 and 2021, AUD prevalence increased by 14.66% globally.
“Between 2000 and 2021, there was a 14.66% increase in AUD, a 38.68% increase in ALD, and a 94.12% increase in alcohol-attributable primary liver cancer prevalence.”
Quote in the paperNot a substantial claim - Findingown data
From 2000 to 2021, ASDR of AUD decreased in all SDI strata except remained stable in high SDI countries.
“ASDR decreased in all SDI strata except remained stable in high SDI countries”
Quote in the paperNot a substantial claim - Findingown data
From 2000 to 2021, changes in ALD and AUD were less pronounced in females than males.
“Regarding sex, changes from 2000 to 2021 from ALD and AUD were less pronounced in females than males (Supplementary Fig. 1A–C).”
Quote in the paperNot a substantial claim - Findingown data
In 2021, there were 132,030 cases of alcohol-attributable primary liver cancer globally.
“In 2021, there were 111.12 million cases of AUD, 3.02 million cases of ALD, and 132,030 cases of alcohol-attributable primary liver cancer.”
Quote in the paperNot a substantial claim - Findingown data
From 2000 to 2021, the age-standardized death rate for alcohol-attributable primary liver cancer remained stable.
“ASDRs remained stable in alcohol-attributable primary liver cancer”
Quote in the paperNot a substantial claim - Findingown data
From 2019 to 2021, ALD mortality increased more in females (1.07%) than in males (0.88%).
“However, ALD metrics increased more in females: prevalence by 4.90%, incidence by 4.96%, and mortality by 1.07%. In males, prevalence increased by 3.87%, incidence by 3.73%, and mortality by 0.88% (Supplementary Fig. 1D–F).”
Quote in the paperNot a substantial claim - Findingown data
In 2021, there were 111.12 million cases of alcohol use disorder (AUD) globally.
“In 2021, there were 111.12 million cases of AUD, 3.02 million cases of ALD, and 132,030 cases of alcohol-attributable primary liver cancer.”
Quote in the paperNot a substantial claim - Findingown data
From 2000 to 2021, the age-standardized death rate for AUD declined (APC -2.19%; 95% CI -2.44 to -1.93%).
“but declined in AUD (APC –2.19%; 95% CI –2.44 to –1.93%)”
Quote in the paperNot a substantial claim - Findingown data
From 2019 to 2021, AUD prevalence increased in males.
“From 2019 to 2021, AUD prevalence and incidence increased in males, whereas it decreased in females (Supplementary Fig. 1D–E).”
Quote in the paperNot a substantial claim - Findingown data
From 2000 to 2021, the age-standardized incidence rate for alcohol-attributable primary liver cancer increased (APC 0.26%; 95% CI 0.22 to 0.30%).
“Similarly, the trend of ASIR increased from alcohol-attributable primary liver cancer (APC 0.26%; 95% CI 0.22 to 0.30%)”
Quote in the paperNot a substantial claim - Findingown data
Between 2000 and 2021, ALD prevalence increased by 38.68% globally.
“Between 2000 and 2021, there was a 14.66% increase in AUD, a 38.68% increase in ALD, and a 94.12% increase in alcohol-attributable primary liver cancer prevalence.”
Quote in the paperNot a substantial claim - Findingown data
In 2021, the highest ASPR of ALD was observed in Eastern Europe (125.22).
“In 2021, the highest ASPR of ALD was observed in Eastern Europe, with an ASPR of 125.22 (95% UI 102.77 to 148.78).”
Quote in the paperNot a substantial claim - Findingown data
From 2000 to 2021, ASDR of alcohol-attributable primary liver cancer exhibited most pronounced increases in Southern Latin America (APC 3.09%), Australasia (2.47%), and High-income North America (2.30%).
“Similarly, ASDR exhibited the most pronounced increases in Southern Latin America (APC 3.09%; 95% CI 2.74 to 3.45%), Australasia (APC 2.47%; 95% CI 1.79 to 3.15%), and High-income North America (APC 2.30%; 95% CI 1.87 to 2.73%)”
Quote in the paperNot a substantial claim - Findingown data
From 2000 to 2021, around 40 countries/territories showed an uptrend of ASPR from AUD.
“Around 40 countries/ territories showed an uptrend of ASPR from AUD.”
Quote in the paperNot a substantial claim - Findingown data
In 2021, the highest burden of alcohol-attributable primary liver cancer in terms of ASRs was observed in Australasia, with ASPR 3.77, ASIR 2.32, and ASDR 1.92.
“In 2021, the highest burden of alcohol-attributable primary liver cancer in terms of ASRs was observed in Australasia, with an ASPR, ASIR, and ASDR of 3.77 (95% UI 3.03 to 4.61), 2.32 (95% UI 1.87 to 2.86), and 1.92 (95% UI 1.53 to 2.37), respectively”
Quote in the paperNot a substantial claim - Findingreasoning
From 2019 to 2021, females experienced a greater increase in ALD prevalence compared to males.
“Interestingly, our study found that from 2019 to 2021, females experienced a greater increase in ALD prevalence compared to males.”
Quote in the paperNot a substantial claim - Findingown data
From 2000 to 2021, ASPR, ASIR, and ASDR of ALD demonstrated a downward trend in most GBD regions.
“The ASPR, ASIR, and ASDR of ALD demonstrated a downward trend in most GBD regions from 2000 to 2021”
Quote in the paperSubstantial claim - Findingnone given
During the COVID-19 pandemic, females exhibited a higher increase in prevalence, incidence, and mortality from ALD compared to males, in contrast to prior to the pandemic.
“During the COVID-19 pandemic, females exhibited a higher increase in prevalence, incidence, and mortality from ALD compared to males, in contrast to prior to the pandemic.”
Quote in the paperNot a substantial claim - Findingown data
From 2000 to 2021, 111 countries/territories showed increasing trends of ASPR for liver cancer from alcohol.
“111 countries/territories showed increasing trends of ASPR for liver cancer from alcohol”
Quote in the paperNot a substantial claim - Findingown data
From 2000 to 2021, Australasia (APC 3.52%), Southern Latin America (3.46%), and High-income North America (2.72%) experienced the most notable changes in ASPR of alcohol-attributable primary liver cancer.
“From 2000 to 2021, Australasia (APC 3.52%; 95% CI 3.24 to 3.80%), Southern Latin America (APC 3.46%; 95% CI 3.32 to 3.60%), and High-income North America (APC 2.72%; 95% CI 2.58 to 2.86%) experienced the most notable changes in ASPR”
Quote in the paperNot a substantial claim - Findingown data
From 2000 to 2021, ASPR, ASIR, and ASDR of ALD decreased in all SDI strata.
“In this timeframe, ASPR, ASIR, and ASDR decreased in all SDI strata”
Quote in the paperNot a substantial claim - Findingown data
From 2000 to 2021, Poland (APC 7.11%), United Kingdom (4.91%), Sweden (4.87%), and Guatemala (4.09%) exhibited the highest rising trends in ASPR of alcohol-attributable primary liver cancer.
“From 2000 to 2021, Poland (APC 7.11%; 95% CI 6.33 to 7.89%), United Kingdom (APC 4.91%; 95% CI 4.66 to 5.16%), Sweden (APC 4.87%; 95% CI 4.49 to 5.25%), and Guatemala (APC 4.09%; 95% CI 3.70 to 4.48%) exhibited the highest rising trends.”
Quote in the paperNot a substantial claim - Findingown data
In 2021, the ASPR of alcohol-attributable primary liver cancer was highest in Mongolia (17.07), followed by Republic of Korea (6.12), Gambia (6.07), and Austria (5.12).
“Classified by country, the ASPR of alcohol-attributable primary liver cancer was highest in Mongolia with an ASPR of 17.07 (95% UI 11.56 to 25.43), followed by Republic of Korea at 6.12 (95% UI 4.02 to 9.14), Gambia at 6.07 (95% UI 3.38 to 10.00), and Austria at 5.12 (95% UI 4.23 to 6.06)”
Quote in the paperNot a substantial claim - Findingreasoning
During the COVID-19 pandemic, the change in incidence and mortality from AUD, ALD, and liver cancer from alcohol exhibited a lower increase compared to pre-pandemic trends.
“Our study found that during the COVID-19 pandemic, the change in incidence and mortality from AUD, ALD, and liver cancer from alcohol exhibited a lower increase compared to pre-pandemic trends”
Quote in the paperSubstantial claim - Findingown data
In 2021, ASIR and ASDR of ALD were highest in Central Asia (18.56 and 11.63, respectively).
“In contrast, ASIR and ASDR were highest in Central Asia, with 18.56 (95% UI 14.78 to 22.14) and 11.63 (95% UI 9.26 to 14.28), respectively”
Quote in the paperNot a substantial claim - Findingown data
From 2000 to 2021, around one-fourth of countries and territories exhibited an uptrend in the prevalence rate of ALD.
“From 2000 to 2021, around one-fourth of countries and territories exhibited an uptrend in the prevalence rate of ALD.”
Quote in the paperNot a substantial claim - Study design and conductreasoning
The GBD estimation methodology often leads to an underestimation of mortality, particularly in low-income countries, due to the absence of high-quality data and underreported risk factors attributable to stigma around alcohol and its related health consequences.
“Furthermore, the estimation methodology used by the GBD often leads to an underestimation of mortality, particularly in low-income countries, attributed to the absence of high-quality data and underreported risk factors attributable to the stigma around alcohol and its related health consequences.”
Quote in the paperNot a substantial claim - Interpretationcitation
The observed decline in AUD may be partly explained by self-underreporting of alcohol consumption, especially during the pandemic, when limited healthcare access, heightened stigma in remote surveys, and disruptions in data collection likely played a role.
“This may partly explain the observed decline in AUD in our findings, especially during the pandemic, when limited healthcare access, heightened stigma in remote surveys, and disruptions in data collection likely played a role [44].”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [44] source
Not checked in the free run.
- Interpretationcitation
Factors beyond alcohol consumption contribute to the rising prevalence of ALD and primary liver cancer.
“Our findings suggest that factors beyond alcohol consumption contribute to the rising prevalence of ALD and primary liver cancer [25,26].”
Quote in the paperSubstantial claim0 of 2 sources checked - Study design and conductcitation
The study has limitations related to the availability and quality of primary data, mainly influenced by the efficacy of vital registration systems in each country.
“We acknowledge several limitations, which are common challenges encountered in GBD studies and relate to the availability and quality of primary data, mainly influenced by the efficacy of vital registration systems in each country [1,22].”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [1] 2024
Not checked in the free run.
- cites [22] source
Not checked in the free run.
- Classified as probably not a substantial claim. 21
- May combine two claims. 19
- The quote only partly states this claim. 1
Probably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataIn 2021, the age-standardized incidence rate of ALD was 5.34 (95% UI 4.40 to 6.25).
“The ASIRs of these conditions were 673.98 (95% UI 563.13 to 776.68), 5.34 (95% UI 4.40 to 6.25), and 1.14 (95% UI 0.93 to 1.38), respectively”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataIn 2021, the highest burden of AUD was observed in Eastern Europe, with ASPR 3,292.73, ASIR 1,634.85, and ASDR 10.66.
“The highest burden of AUD was observed in Eastern Europe, where the ASPR, ASIR, and ASDR were 3,292.73 (95% UI 2,901.33 to 3,724.07), 1,634.85 (95% UI 1,373.51 to 1,906.75), and 10.66 (95% UI 9.82 to 11.56), respectively”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataIn 2021, high SDI countries exhibited the highest burden of AUD with ASPR 1,847.63, ASIR 915.37, and ASDR 2.58.
“When evaluated against the SDI, high SDI countries exhibited the highest burden of AUD with ASPR, ASIR, and ASDR of 1,847.63 (95% UI 1,603.23 to 2,115.44), 915.37 (95% UI 772.84 to 1,052.98), and 2.58 (95% UI 2.50 to 2.66), respectively”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataIn 2021, the age-standardized prevalence rate of alcohol-attributable primary liver cancer was 1.51 (95% UI 1.23 to 1.82).
“The ASPRs of AUD, ALD, and primary liver cancer from alcohol were 1,335.43 (95% UI 1,153.65 to 1,539.75), 34.81 (95% UI 28.88 to 40.26), and 1.51 (95% UI 1.23 to 1.82), respectively”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataIn 2021, the age-standardized incidence rate of alcohol-attributable primary liver cancer was 1.14 (95% UI 0.93 to 1.38).
“The ASIRs of these conditions were 673.98 (95% UI 563.13 to 776.68), 5.34 (95% UI 4.40 to 6.25), and 1.14 (95% UI 0.93 to 1.38), respectively”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataIn 2021, there were 158,470 deaths from AUD globally (-3.23% from 2000).
“There were 158,470 deaths from AUD (-3.23% from 2000), 354,250 deaths from ALD (+32.60% from 2000), and 92,230 deaths from alcohol-attributable primary liver cancer (+76.75% from 2000)”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataIn 2021, the age-standardized death rate of AUD was 1.84 (95% UI 1.50 to 2.01).
“The ASDRs were 1.84 (95% UI 1.50 to 2.01), 4.08 (95% UI 3.45 to 4.81), and 1.06 (95% UI 0.86 to 1.29) for AUD, ALD, and alcohol-attributable primary liver cancer, respectively”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataIn 2021, the age-standardized prevalence rate of ALD was 34.81 (95% UI 28.88 to 40.26).
“The ASPRs of AUD, ALD, and primary liver cancer from alcohol were 1,335.43 (95% UI 1,153.65 to 1,539.75), 34.81 (95% UI 28.88 to 40.26), and 1.51 (95% UI 1.23 to 1.82), respectively”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataIn 2021, the age-standardized death rate of alcohol-attributable primary liver cancer was 1.06 (95% UI 0.86 to 1.29).
“The ASDRs were 1.84 (95% UI 1.50 to 2.01), 4.08 (95% UI 3.45 to 4.81), and 1.06 (95% UI 0.86 to 1.29) for AUD, ALD, and alcohol-attributable primary liver cancer, respectively”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataIn 2021, the age-standardized incidence rate of AUD was 673.98 (95% UI 563.13 to 776.68).
“The ASIRs of these conditions were 673.98 (95% UI 563.13 to 776.68), 5.34 (95% UI 4.40 to 6.25), and 1.14 (95% UI 0.93 to 1.38), respectively”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataIn 2021, there were 99,540 new cases of alcohol-attributable liver cancer globally (+82.89% from 2000).
“In terms of incidence, there were 55.78 million new cases of AUD (+15.24% from 2000), 462,690 cases of ALD (+38.29% from 2000), and 99,540 cases of alcohol-attributable liver cancer (+82.89% from 2000)”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataIn 2021, the age-standardized death rate of ALD was 4.08 (95% UI 3.45 to 4.81).
“The ASDRs were 1.84 (95% UI 1.50 to 2.01), 4.08 (95% UI 3.45 to 4.81), and 1.06 (95% UI 0.86 to 1.29) for AUD, ALD, and alcohol-attributable primary liver cancer, respectively”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataIn 2021, there were 92,230 deaths from alcohol-attributable primary liver cancer globally (+76.75% from 2000).
“There were 158,470 deaths from AUD (-3.23% from 2000), 354,250 deaths from ALD (+32.60% from 2000), and 92,230 deaths from alcohol-attributable primary liver cancer (+76.75% from 2000)”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataIn 2021, there were 462,690 new cases of ALD globally (+38.29% from 2000).
“In terms of incidence, there were 55.78 million new cases of AUD (+15.24% from 2000), 462,690 cases of ALD (+38.29% from 2000), and 99,540 cases of alcohol-attributable liver cancer (+82.89% from 2000)”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataIn 2021, there were 354,250 deaths from ALD globally (+32.60% from 2000).
“There were 158,470 deaths from AUD (-3.23% from 2000), 354,250 deaths from ALD (+32.60% from 2000), and 92,230 deaths from alcohol-attributable primary liver cancer (+76.75% from 2000)”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataFrom 2000 to 2021, ASPR of AUD declined across most regions, but increased in Australasia (APC 0.72%), Oceania (APC 0.13%), and Western Sub-Saharan Africa (APC 0.08%).
“While a decline in ASPR was observed across most regions, ASPR was increased in Australasia (APC 0.72%; 95% CI 0.59 to 0.84%), Oceania (APC 0.13%; 95% CI 0.11 to 0.15%), and Western Sub-Saharan Africa (APC 0.08%; 95% CI 0.05 to 0.11%)”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Findingown dataIn 2021, there were 55.78 million new cases of AUD globally (+15.24% from 2000).
“In terms of incidence, there were 55.78 million new cases of AUD (+15.24% from 2000), 462,690 cases of ALD (+38.29% from 2000), and 99,540 cases of alcohol-attributable liver cancer (+82.89% from 2000)”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataIn 2021, the age-standardized prevalence rate of AUD was 1,335.43 (95% UI 1,153.65 to 1,539.75).
“The ASPRs of AUD, ALD, and primary liver cancer from alcohol were 1,335.43 (95% UI 1,153.65 to 1,539.75), 34.81 (95% UI 28.88 to 40.26), and 1.51 (95% UI 1.23 to 1.82), respectively”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataFrom 2000 to 2021, ASIR of AUD decreased in most regions, but increased in Australasia (APC 0.76%), Oceania (APC 0.12%), and Western Sub-Saharan Africa (APC 0.10%).
“Considering ASIR, most regions exhibited a decrease, but increased in Australasia (APC 0.76%; 95% CI 0.65 to 0.86%), Oceania (APC 0.12%; 95% CI 0.10 to 0.14%), and Western Sub-Saharan Africa (APC 0.10%; 95% CI 0.07 to 0.12%)”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataFrom 2000 to 2021, ASDR of ALD increased in Eastern Europe (APC 0.99%) and High-income North America (0.74%).
“ASDR increased in Eastern Europe (APC 0.99%; 95% CI 0.58 to 1.41%) and High-income North America (APC 0.74%; 95% CI 0.38 to 1.10%)”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataFrom 2000 to 2021, ASPR of alcohol-attributable primary liver cancer increased in high (APC 1.10%), middle (0.96%), and low-middle SDI countries (0.93%).
“In terms of SDI, ASPR of alcohol-attributable primary liver cancer increased in high (APC 1.10%; 95% CI 1.05 to 1.16%), middle (APC 0.96%; 95% CI 0.89 to 1.04%), and low-middle SDI countries (APC 0.93%; 95% CI 0.89 to 0.97%)”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataFrom 2000 to 2021, ASIR of alcohol-attributable primary liver cancer increased in low-middle (APC 0.90%), middle (0.61%), and high SDI strata (0.56%).
“From the designated time frame, ASIR increased in low-middle (APC 0.90%; 95% CI 0.85 to 0.94%), middle (APC 0.61%; 95% CI 0.53 to 0.69%), and high SDI strata (APC 0.56%; 95% CI 0.51 to 0.62%)”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataThe study revealed a noteworthy rise in ALD and alcohol-attributable primary liver cancer burden both from the past two decades and during the COVID-19 pandemic.
“The study also revealed a noteworthy rise in ALD and alcohol-attributable primary liver cancer burden both from the past two decades and during the COVID-19 pandemic.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataFrom 2000 to 2021, ASPR of ALD increased in Central Asia (APC 0.88%), Eastern Europe (0.68%), Central Sub-Saharan Africa (0.16%), and South Asia (0.10%).
“However, Central Asia (APC 0.88%; 95% CI 0.79 to 0.97%), Eastern Europe (APC 0.68%; 95% CI 0.53 to 0.82%), Central Sub-Saharan Africa (APC 0.16%; 95% CI 0.14 to 0.18%), and South Asia (APC 0.10%; 95% CI 0.08 to 0.13%) exhibited an uptrend in ASPR.”
Quote in the paperNot a substantial claimMay combine two claims.
FindingreasoningAlthough AUD was more frequent in countries with high SDI, countries with lower SDI exhibited higher ASDRs from ALD.
“Of note, although AUD was more frequent in countries with high SDI, countries with lower SDI exhibited higher ASDRs from ALD”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataIn 2021, the ASPR of ALD was highest in the Republic of Moldova (182.41), followed by Ukraine (146.50), Mongolia (145.63), and Turkmenistan (130.18).
“In short, the ASPR of ALD was highest in the Republic of Moldova with an ASPR of 182.41 (95% UI 145.28 to 220.48), followed by Ukraine at 146.50 (95% UI 118.14 to 178.47), Mongolia at 145.63 (95% UI 115.28 to 174.84), and Turkmenistan at 130.18 (95% UI 100.91 to 157.40)”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataFrom 2000 to 2021, ASIR of ALD increased in Eastern Europe (APC 0.47%) and Central Asia (0.44%).
“ASIR increased in Eastern Europe (APC 0.47%; 95% CI 0.35 to 0.59%) and Central Asia (APC 0.44%; 95% CI 0.32 to 0.56%)”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataFrom 2000 to 2021, ASIR of alcohol-attributable primary liver cancer increased in two-thirds of regions, with highest upward progression in Southern Latin America (APC 3.26%), Australasia (2.79%), and High-income North America (2.46%).
“ASIR increased in two-thirds of regions, with the highest upward progression observed in Southern Latin America (APC 3.26%; 95% CI 3.03 to 3.50%), Australasia (APC 2.79%; 95% CI 2.54 to 3.04%), and High-income North America (APC 2.46%; 95% CI 2.32 to 2.60%)”
Quote in the paperNot a substantial claimThe quote only partly states this claim.
Findingown dataFrom 2000 to 2021, New Zealand (APC 3.46%), Mongolia (1.49%), Taiwan (1.24%), and Uruguay (0.64%) exhibited the highest increases of ASPR from AUD.
“New Zealand (APC 3.46%; 95% CI 3.21 to 3.70%), Mongolia (APC 1.49%; 95% CI 1.30 to 1.67%), Taiwan (APC 1.24%; 95% CI 0.95 to 1.52%), and Uruguay (APC 0.64%; 95% CI 0.56 to 0.72%) exhibited the highest increases of ASPR from 2000 to 2021”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataIn 2021, the ASPR of AUD was highest in Mongolia (4,716.94), followed by Guatemala (4,049.97), El Salvador (3,917.28), and Kazakhstan (3,895.96).
“Briefly, the ASPR of AUD was highest in Mongolia with an ASPR of 4,716.94 (95% UI 3,986.35 to 5,453.81), followed by Guatemala at 4,049.97 (95% UI 3,444.01 to 4,623.66), El Salvador at 3,917.28 (95% UI 3,312.16 to 4,461.73), and Kazakhstan at 3,895.96 (95% UI 3,302.65 to 4,889.17)”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataFrom 2000 to 2021, ASDR of alcohol-attributable primary liver cancer increased in low-middle (APC 0.89%), middle (0.35%), and high SDI countries (0.27%).
“Similarly, ASDR increased in low-middle (APC 0.89%; 95% CI 0.70 to 1.09%), middle (APC 0.35%; 95% CI 0.18 to 0.52%), and high SDI countries (APC 0.27%; 95% CI 0.06 to 0.48%)”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataIn 2021, high SDI countries exhibited the highest ASPR of ALD (39.37), whereas low SDI countries exhibited the highest ASIR (7.79) and ASDR (5.94).
“Regarding SDI, high SDI countries exhibited the highest ASPR with a value of 39.37 (95% UI 32.74 to 45.26), whereas low SDI countries exhibited the highest ASIR and ASDR with a value of 7.79 (95% UI 6.10 to 9.66) and 5.94 (95% UI 4.43 to 7.78), respectively”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataFrom 2000 to 2021, 49 countries/territories exhibited an uptrend in ASPR of ALD, with highest ascending trends in Kazakhstan (APC 1.74%), Armenia (1.60%), Turkmenistan (1.35%), and Ukraine (1.21%).
“49 countries/ territories exhibited an uptrend, with the highest ascending trends observed in Kazakhstan (APC 1.74%; 95% CI 1.50 to 1.98%), Armenia (APC 1.60%; 95% CI 1.42 to 1.77%), Turkmenistan (APC 1.35%; 95% CI 1.29 to 1.41%), and Ukraine (APC 1.21%; 95% CI 0.90 to 1.53%)”
Quote in the paperNot a substantial claimMay combine two claims.
InterpretationcitationImproved screening and diagnostic techniques allow for earlier and more accurate detection, while changes in disease registry systems may enhance the ability to capture current epidemiological trends, potentially leading to higher reported prevalence rates.
“Improved screening and diagnostic techniques allow for earlier and more accurate detection, while changes in disease registry systems may enhance the ability to capture current epidemiological trends, potentially leading to higher reported prevalence rates [27,28].”
Quote in the paperNot a substantial claim0 of 2 sources checkedMay combine two claims.
Study design and conductcitationGBD estimated AUD using ICD-10 codes rather than the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, which can lead to an underestimation of the true burden of AUD, ALD, and alcohol-attributable liver cancer.
“Additionally, GBD estimated AUD using ICD-10 codes rather than the Diagnostic and Statistical Manual of Mental Disorders, 5th edition. This can lead to an underestimation of the true burden of AUD, ALD, and alcohol-attributable liver cancer in these regions [1,45].”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [1] 2024
Not checked in the free run.
- cites [45] source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
InterpretationcitationWhile overall AUD prevalence may be declining, higher-risk drinking behaviors, such as binge-drinking, among specific populations could be on the rise.
“Furthermore, while overall AUD prevalence may be declining, higher-risk drinking behaviors, such as binge-drinking, among specific populations could be on the rise [29,30].”
Quote in the paperNot a substantial claim0 of 2 sources checkedProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductcitationThe report on alcohol use tends to be underestimated.
“The report on alcohol use also tends to be underestimated [46].”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [46] source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenThe GBD analysis framework is currently limited to attributing a single cause to a specific outcome, preventing the inclusion of co-variation with other relevant risk factors.
“In addition, the GBD analysis framework is currently limited to attributing a single cause to a specific outcome, preventing the inclusion of co-variation with other relevant risk factors.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenThe analysis based on geographical and SDI strata is not fully comprehensive for social determinants of health.
“Also, we performed our analysis based on geographical and SDI strata, which comprise many factors of social determinants of health; however, it is not fully comprehensive.”
Quote in the paperNot a substantial claim
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Current OUD treatments focus on harm reduction through opioid replacement, without restoring neurochemical balance.
“Yet current OUD treatments focus on harm reduction through opioid replacement, without restoring neurochemical balance.”
From Beyond Stigma–Integrating Neurobiology, Genetics, and Awareness Integration Theory in Addiction Recovery (2026) · cites this paper as [103]
The Introduction discusses treatment access for alcohol use disorder (AUD), not opioid use disorder (OUD). Searches for opioid replacement, harm reduction, and neurochemical balance found no passage in our copy addressing the claim. (LLM, conf=0.76)
Experimental — accuracy not yet measuredGARS Testing involves use of a 10-gene panel to predict addiction severity using the Addiction Severity Index (ASI), enabling early identification of genetic predisposition to substance use disorders.
“GARS Testing involves the use of a 10-gene panel to predict addiction severity using the Addiction Severity Index (ASI), thereby enabling early identification of genetic predisposition to substance use disorders.”
From Beyond Stigma–Integrating Neurobiology, Genetics, and Awareness Integration Theory in Addiction Recovery (2026) · cites this paper as [103]
The Materials and Methods (Data source; Estimation methods, page unavailable) describe GBD 2021 data and ICD-10 codes for alcohol use disorder, not a genetic test. Searches for GARS, a 10-gene panel, the Addiction Severity Index, and genetic predisposition found no passage addressing the claim. (LLM, conf=0.78)
Experimental — accuracy not yet measuredPBM integrates five key components designed to personalize addiction treatment and address underlying neurobiological imbalances.
“PBM integrates five key components designed to personalize addiction treatment and address underlying neurobiological imbalances.”
From Beyond Stigma–Integrating Neurobiology, Genetics, and Awareness Integration Theory in Addiction Recovery (2026) · cites this paper as [103]
The Introduction discusses multidisciplinary treatment for alcohol use disorder and liver disease, but does not describe PBM or a five-component treatment model. Searches for PBM, personalized addiction treatment, and neurobiological imbalances found no passage addressing the claim. (LLM, conf=0.76)
Experimental — accuracy not yet measuredPro-Dopamine Regulation (KB220Z) utilizes targeted nutrient-based therapies to restore dopamine homeostasis, reduce craving, and prevent relapse.
“Pro-Dopamine Regulation (KB220Z) utilizes targeted nutrient-based therapies, administered intravenously or orally, to restore dopamine homeostasis, reduce craving, and prevent relapse.”
From Beyond Stigma–Integrating Neurobiology, Genetics, and Awareness Integration Theory in Addiction Recovery (2026) · cites this paper as [103]
The Introduction discusses access to behavioral and pharmacological treatment for alcohol use disorder, but does not address KB220Z. Searches for Pro-Dopamine Regulation, dopamine homeostasis, nutrient-based therapy, craving, and relapse found no passage supporting the attributed treatment mechanism or outcomes. (LLM, conf=0.75)
Experimental — accuracy not yet measuredCARD offers real-time monitoring of treatment compliance and abstinence from illicit substances, serving as a critical accountability and safety mechanism during recovery.
“Comprehensive Analysis of Reported Drugs (CARD™) offers real-time monitoring of treatment compliance and abstinence from illicit substances, serving as a critical accountability and safety mechanism during recovery.”
From Beyond Stigma–Integrating Neurobiology, Genetics, and Awareness Integration Theory in Addiction Recovery (2026) · cites this paper as [103]
The Introduction discusses access to alcohol use disorder treatment, and the Results report epidemiological trends; neither addresses CARD. Searches for its full name, real-time compliance monitoring, and illicit-substance abstinence found no passage describing the claimed mechanism. (LLM, conf=0.78)
Experimental — accuracy not yet measured
DNA-Directed Gene Expression Profiling allows clinicians to track mRNA expression patterns and guide therapeutic decisions, optimizing treatment outcomes.
“DNA-Directed Gene Expression Profiling allows clinicians to track mRNA expression patterns and guide therapeutic decisions, optimizing treatment outcomes through precision targeting of the brain’s reward circuitry.”
From Beyond Stigma–Integrating Neurobiology, Genetics, and Awareness Integration Theory in Addiction Recovery (2026) · cites this paper as [103]
The Materials and Methods (Data source and Statistical analysis; page unavailable) describe an analysis of global alcohol-related disease data, not gene-expression profiling. Searches for DNA-directed profiling, mRNA expression, and precision targeting of brain reward circuitry found no passage addressing the attributed claim. (LLM, conf=0.78)
Experimental — accuracy not yet measuredThe RDS Questionnaire is a validated tool that helps phenotype reward deficiency syndromes by assessing behavioral and cognitive traits linked to dopaminergic dysfunction.
“The RDS Questionnaire is a validated tool that helps phenotype reward deficiency syndromes by assessing behavioral and cognitive traits linked to dopaminergic dysfunction.”
From Beyond Stigma–Integrating Neurobiology, Genetics, and Awareness Integration Theory in Addiction Recovery (2026) · cites this paper as [103]
The Results section on alcohol use disorder reports population-level prevalence, incidence, and mortality, not a questionnaire for phenotyping reward deficiency syndrome. Searches for the RDS Questionnaire and for dopaminergic dysfunction and behavioral or cognitive traits found no passage in our copy addressing the claimed tool or its validation. No page numbers are available in the indexed passages. (LLM, conf=0.76)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Five etiologies are claimed but only four are listed
MinorThe text calls this a list of five etiologies, but names only hepatitis B, hepatitis C, ALD, and metabolic dysfunction associated steatohepatitis.
“Data for five etiologies”
“—chronic hepatitis B virus infection, chronic hepatitis C virus infection, ALD, metabolic dysfunction associated steatohepatitis.”
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Meyers, J., McCutcheon, V., Horne-Osipenko, K. A., Waters, L. R., Barr, P. B., Chan, G., Chorlian, D., Johnson, E., Kuo, S., Kramer, J., et al. (2023) · Translational Psychiatry · doi:10.1038/s41398-023-02577-1 · Cited by 14 · see citing works
The Global Burden of Disease Epidemiology—When Big Data Impute the Nonexistent
Roman-Urrestarazu, A., & van Kessel, R. (2024) · JAMA Pediatrics · doi:10.1001/jamapediatrics.2023.6507 · Cited by 11 · see citing works
Roblero, J. P., Díaz, L. A., Arab, J. P., Roblero, P., & Bataller, R. A. (2021) · The Lancet Regional Health - Europe · doi:10.1016/j.lanepe.2021.100229 · Cited by 10 · see citing works
Self-citationKnapen, F. M. F. M., Laumer, S. J. M., van Osch, F., et al. (2021) · Drug and Alcohol Review · doi:10.1111/dar.13410 · Cited by 7 · see citing works
Wang, Y., Huang, Y., Sun, C., Chung, H., Taner, C. B., & Yang, L. (2024) · Journal of General Internal Medicine · doi:10.1007/s11606-023-08594-6 · Cited by 7 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- Global status report on alcohol and health and treatment of substance use disorders
Cited by
Sorted by citations
Blum, K., Gold, M., Jafari, N., Lewandrowski, K.-U., Sharafshah, A., Mohankumar, K., Lorio, M., Bowirrat, A., Pinhasov, A., Thanos, K., et al. (2026) · Psychology Research and Behavior Management · doi:10.2147/prbm.s561157 · Cited by 1 · see citing works
- Authors
- Danpanichkul, P., Díaz, L. A., Suparan, K., Tothanarungroj, P., Sirimangklanurak, S., Auttapracha, T., Blaney, H. L., Sukphutanan, B., Pang, Y., Kongarin, S., Idalsoaga, F., Fuentes-López, E., Leggio, L., Noureddin, M., White, T. M., Louvet, A., Mathurin, P., Loomba, R., Kamath, P. S., Rehm, J., Lazarus, J. V., Wijarnpreecha, K., & Arab, J. P.
- Affiliations
- Texas Tech University (US)
- Pontificia Universidad Católica de Chile (CL)
- Chiang Mai University (TH)
- University of Maryland, Baltimore (US)
- Lerdsin Hospital (TH)
- Youjiang Medical College for Nationalities (CN)
- National Institutes of Health (US)
- Houston Methodist (US)
- The Graduate Center, CUNY (US)
- Université de Lille (FR)
- University of California San Diego (US)
- Mayo Clinic (US)
- Centre for Addiction and Mental Health (CA)
- Banner - University Medical Center Phoenix (US)
- Corresponding author
- Arab, Juan Pablo
- ORCID
- Danpanichkul, Pojsakorn
- Díaz, Luis Antonio
- Suparan, Kanokphong
- Tothanarungroj, Primrose
- Sirimangklanurak, Supapitch
- Auttapracha, Thanida
- Blaney, Hanna L.
- Sukphutanan, Banthoon
- Pang, Yanfang
- Kongarin, Siwanart
- Idalsoaga, Francisco
- Fuentes-López, Eduardo
- Leggio, Lorenzo
- Noureddin, Mazen
- White, Trenton M.
- Louvet, Alexandre
- Mathurin, Philippe
- Loomba, Rohit
- Kamath, Patrick S.
- Rehm, Jürgen
- Lazarus, Jeffrey V.
- Wijarnpreecha, Karn
- Arab, Juan Pablo
- Venue
- Clinical and Molecular Hepatology
- Published
- 2025-04-01
- Volume
- 31
- Issue
- 2
- Pages
- 525-547
- ISSN
- 2287-2728 (ISSN-L)
- 2287-285X
- PMC
- PMC12016609
- OpenAlex
- W4406203838
- Semantic Scholar
- 9af19dd7591ca9bee2ad6c03b099a67a831a0398
- Cited by
- 85
- References
- 49
- Citations by year
- 2026: 52 · 2025: 33
- FWCI
- 56.16
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Clinical and Molecular Hepatology (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National Institutes of Health
- National Center for Advancing Translational Sciences (5UL1TR001442)
- National Institute of Diabetes and Digestive and Kidney Diseases (P30DK120515)
- National Heart, Lung, and Blood Institute (P01HL147835)
- John C. Martin Foundation (RP124)
- National Institute on Alcohol Abuse and Alcoholism (U01AA029019)
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Business, Management and Accounting › Organizational Behavior and Human Resource Management › Global Public Health Policies and Epidemiology
- Keywords
- alcoholic liver disease, alcoholism, global burden of disease, prevalence trends, incidence, mortality, sex differences, regional variation, socio-economic development, alcohol prevention
- MeSH terms
- Global Burden of Disease, Adult, Aged, Alcoholism, Female, Humans, Liver Diseases, Alcoholic, Liver Neoplasms, Male, Middle Aged, Global Health, Prevalence, Databases, Factual, Young Adult
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.
Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-09.
Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-09.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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