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.

Background/Objectives: The incidence and mortality of early-onset cancers have been rising in recent decades. While epidemiological studies have examined various types of cancer, updated global data on alcohol-attributable primary liver cancer (PLC) in young adults remains limited. Methods: This study utilized data from the Global Burden of Disease (GBD) study spanning 2000 to 2021 to evaluate the age-standardized incidence, mortality, and corresponding rates of alcohol-attributable PLC among young adults aged 15–49 years. Results: In 2021, there were 8290 incidence cases and 6590 deaths from alcohol-attributable PLC in young adults. The age-standardized incidence rate has increased in Europe (annual percent change [APC]: 0.44%, 95%CI 0.35 to 0.54%), Southeast Asia (APC: 0.40%, 95% CI 0.37 to 0.44%), and the Western Pacific region (APC: 0.65%, 95% CI 0.44 to 0.86%). In 2021, alcohol-attributable PLC in young adults represented 11% (+2% from 2000) of incident cases and 11% of (+2% from 2000) deaths among all PLC in young adults. About half of the countries showed an increase in the age-standardized incidence rate of alcohol-attributable PLC among young adults between 2000 and 2021. Conclusions: The incidence rate of alcohol-attributable liver cancer in young adults has shifted significantly over the past two decades, with notable increases in Europe and the Asia–Pacific region. This trend underscores the need for global strategies to address the rising prevalence of alcohol use disorder and alcohol-associated liver disease and their impact on young adults.

Background/Objectives: Early-onset cancer is an emerging global health concern, including in the United States. However, data on early-onset liver and intrahepatic bile duct cancer remain limited. This study aims to fill this gap by analyzing trends in early-onset liver and intrahepatic bile duct cancer in the United States over the past two decades. Methods: This study used National Childhood Cancer Registry data to examine temporal trends in early-onset liver and intrahepatic bile duct cancer in the United States. The analysis involved estimating age-adjusted incidence rates of early-onset liver and intrahepatic bile duct cancer, stratified by histological type, ethnicity, and sex. Results: In 2021, the age-adjusted incidence rate of early-onset liver and intrahepatic bile duct cancer was estimated at 0.53 per 100,000 population (95% Confidence Interval [CI]: 0.48–0.59). From 2001 to 2021, the age-adjusted incidence rate showed a significant annual percent change (APC) of 1.35% (95% CI: 0.87–1.83%). When stratified by sex, the age-adjusted incidence rate in females increased significantly (APC: 3.07%, 95% CI: 2.26–3.87%) while remaining stable in males. Among racial and ethnic groups, non-Hispanic American Indian and Alaska Native (AIAN) individuals had the highest age-adjusted incidence rate, recorded at 2.67 per 100,000 population (95% CI: 0.95–5.85). By histological type, hepatic carcinoma had the highest age-adjusted incidence rate, significantly increasing over time (APC: 1.47%, 95% CI: 0.96–1.99%). In contrast, the incidence rates for hepatoblastoma and unspecified hepatic tumors remained stable between 2001 and 2021. Conclusions: Our study identified an increasing incidence of early-onset liver and intrahepatic bile duct cancer in the United States, primarily driven by cases in females and hepatic carcinoma.

Cirrhosis remains a major global cause of morbidity and mortality, with rapidly evolving etiologic drivers. This review summarizes the contemporary global epidemiology of cirrhosis, highlighting regional patterns and major transitions in underlying causes to inform prevention and policy. In 2021, cirrhosis and chronic liver disease accounted for ~1.4 million deaths worldwide. Although age-standardized mortality rates have declined in many regions, the absolute burden continues to rise due to population growth and aging. Reductions in hepatitis B and C–related cirrhosis, driven by vaccination, screening, and antiviral therapy, have been offset by a growing contribution from steatotic liver disease. High–sociodemographic index (SDI) regions exhibit lower mortality but increasing prevalence, reflecting improved survival and expanding metabolic risk, whereas low- and lower-middle–SDI regions continue to experience high mortality. Addressing the global burden of cirrhosis will require sustained public health investment focused on viral hepatitis elimination, alcohol-associated harm reduction, metabolic risk management, and equitable access to early detection and care.