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.

INTRODUCTION: To update the global burden of inflammatory bowel disease (IBD) using data from the Global Burden of Disease 2021. METHODS: Data from Global Burden of Disease 2021 were analyzed to assess the IBD burden. RESULTS: In 2021, there were 375,140 new cases and 3.83 million total cases of IBD. Elderly onset IBD accounted for 11% of incidences. 167 countries increased IBD incidence rate, with rates rising in female patients (APC: +0.06%) and the elderly (APC: +0.14%) but stable in male patients and the overall population. DISCUSSION: Although the global burden of IBD has decreased overall, it has increased in female patients and the elderly.

INTRODUCTION: Obesity is associated with cancer, including gastrointestinal (GI). Data from low (LICs) and lower-middle-income countries (MICs) are limited. METHODS: We utilized data from the Global Burden of Disease Study 2019 to determine the mortality from GI cancer risk of high body mass index (BMI) in these countries. RESULTS: Mortality rates of GI cancers from high BMI increased in LICs and lower MICs, while burdens decreased or remained stable in high and middle-income countries. DISCUSSION: The GI cancer-related burden from high BMI increased in LICs and lower MICs, necessitating a concerted effort to tackle the obesity pandemic.

Background/Objectives: The burden of early-onset cancer (cancer incidence <50 years) has increased globally. Early-onset cancer carries significant societal and economic consequences. We aim to provide updated estimates for incidence and mortality of early-onset cancer. Methods: We analyzed the Global Burden of Disease Study 2021 to describe the incidence, death, age-standardized incidence rate (ASIR), age-standardized death rate (ASDR) from early-onset cancer (i.e., cancer in people aged 15–49), and its changes from 2000 to 2021 (reflected as annual percent change [APC]), using Joinpoint regression analysis. Results: In 2021, there were 3.16 million new cases and 989,650 deaths from early-onset cancer. From 2000 to 2021, the ASIR of early-onset cancer increased (APC: 0.40%, 95% CI 0.32 to 0.47%), with the highest increase observed in the Eastern Mediterranean region (APC: 1.63%, 95% CI 1.53 to 1.72%), whereas the ASDR decreased across most regions. The ASIR for early-onset cancer had a higher increase in females (APC: 0.62%, 95% CI 0.51 to 0.73%) than males (APC: 0.14%, 95% CI 0.04 to 0.23%). Breast cancer (n = 567,900) constituted the highest burden of incident cases, followed by non-melanoma skin (n = 507,810) and cervical cancers (n = 307,430). The highest increase in the ASIR was observed in non-melanoma skin cancer (APC:2.18%, 95% CI 1.85–2.51%), thyroid (APC: 1.70%, 95% CI 1.60 to 1.79%), and testicular (APC:1.37%, 95% CI 0.96 to 1.78%) cancers. The greatest increases in the ASDR were observed in peripheral nervous system cancer (APC: 0.97%, 95% CI 0.82 to 1.11%) and multiple myeloma (APC: 0.62%, 95% CI 0.51 to 0.72%). Conclusions: From 2000 to 2021, the age-adjusted incidence of early-onset cancer increased, with variation across regions and cancer types. Immediate measures are required at a global, regional, and national level to mitigate the burden of early-onset cancer.

Background: The incidence of cancer and the prevalence of metabolic disease and metabolic dysfunction–associated steatotic liver disease is increasing in young adults. However, updated global data on metabolic dysfunction–associated steatohepatitis (MASH)-associated primary liver cancer (PLC) in young adults remains scarce. Methods: This study analyzed data from the Global Burden of Disease study between 2000 and 2021 to assess the age-standardized incidence, mortality, and disability-adjusted life years rates from MASH-associated PLC in young adults (15–49 y). Results: In 2021, there were 4300 incidence cases, 3550 deaths, and 179,340 disability-adjusted life years from MASH-associated PLC in young adults. Among various etiologies of PLC in young adults, only MASH-associated PLC had increased incidence rates (annual percent change: +0.26, 95% CI: 0.16%–0.35%), with the Eastern Mediterranean region having the largest observed increase (annual percent change: 1.46%, 95% CI: 1.40%–1.51%). In 2021, MASH-associated PLC in young adults made up 6% (+1% from 2000) incident cases, 6% (+2% from 2000) deaths, and 6% (+2% from 2000) disability-adjusted life years of all PLC in this age group. Over half of the countries exhibited an increase in age-standardized incidence rate from MASH-associated PLC in young adults from 2000 to 2021. Conclusions: The incidence of MASH-associated PLC in young adults is significantly increasing, signaling likely future increases in PLC incidence among older adults as this cohort ages. This trend necessitates urgent strategies worldwide to mitigate the epidemics of MASH-associated PLC in young adults. Export