China data on the burden of alcohol-associated liver cancer from 1990 to 2021: a systematic analysis from the global burden of disease study 2021

Background: Alcohol consumption is a significant risk factor for liver cancer, particularly hepatocellular carcinoma. In China, the incidence of liver cancer has been rising, necessitating an in-depth analysis of the relationship between alcohol consumption and liver cancer burden. Objective: This study aims to assess the burden of alcohol-associated liver cancer (A-LC) in China from 1990 to 2021, utilising data from the Global Burden of Disease (GBD) Study 2021. Methods: This study first gathered data on A-LC in China, focusing on age, sex, incidence, prevalence, mortality, disability-adjusted life years (DALYs) and risk factors, using information from the 2021 GBD study covering the years 1990-2021. Next, the research examined the temporal trends of A-LC burdens in China during the same period, employing linear regression modeling to calculate estimated annual percentage change (EAPC) values. Additionally, the autoregressive integrated moving average and exponential smoothing model were utilised to project future disease burdens from 2022 to 2050. Finally, the study analysed risk factors associated with A-LC. Results: The number of deaths and DALYs for A-LC grew significantly during the study period 1990-2021 (in 1990, in 2021). However, age-standardised deaths and DALYs declined (deaths: 0.87 in 1990 and 0.85 in 2021, DALYs: 24.26 in 1990 and 22.01 in 2021). EAPC = 0.16 (95% CI 0-0.32) for deaths in patients with A-LC and EAPC = -0.18 (95% CI -0.34 to -0.01) for DALYs. Although age-standardized death rates have declined in the last 3 years, the number of incidence, disease and death cases of A-LC patients in China has increased with the progress of time. In 2021, ASIR and ASPR reached the highest in history and the large base of A-LC patients in China and the overall situation of the people should not be underestimated. While East Asia and the high-income Asia-Pacific region declined over the study period, Central Asia saw an increase in age-standardised DALY rates. Age-standardised DALYs also grew significantly in high-income populations in North America and Australasia. Conclusion: A-LC remains a serious threat to the major health problems of the Chinese people, especially men, and the burden of liver cancer associated with obesity risk factors is also increasing significantly and is expected to continue to grow over the next 25 years.