{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T13:30:53Z","timestamp":1790775053410,"version":"4.1.0"},"reference-count":65,"publisher":"The Korean Association for the Study of the Liver","issue":"3","license":[{"start":{"date-parts":[[2025,4,11]],"date-time":"2025-04-11T00:00:00Z","timestamp":1744329600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["e-cmh.org"],"crossmark-restriction":true},"short-container-title":["CMH"],"published-print":{"date-parts":[[2025,7,1]]},"abstract":"<jats:p>Background\/Aims: Harmful alcohol use is a substantial contributor to liver diseases, liver cancer, and extrahepatic neoplasms. Patterns of alcohol consumption have shifted over recent decades. This study evaluates trends in alcohol-associated liver disease (ALD) and alcohol-attributable cancers in the United States (US) from 2000 to 2021.Methods: Using the methodological framework of the Global Burden of Disease Study 2021, we analyzed trends in incidence, prevalence, and mortality from ALD and alcohol-attributable cancers in the US.Results: In 2021, there were 28,340 new cases of ALD, 227,730 prevalent cases, and 21,860 deaths attributed to ALD in the US. From 2000 to 2021, ALD incidence, prevalence, and mortality increased by 43%, 36%, and 79%, respectively. The age-standardized incidence and death rate of ALD rose disproportionately among females compared to males. For alcohol-attributable cancers, primary liver cancer, colorectal cancer, and esophageal cancer accounted for the largest share of deaths in 2021. Age-standardized death rates increased significantly for primary liver cancer (annual percent change [APC] 2.21%, 95% confidence interval [CI] 1.70\u20132.73%) and other pharyngeal cancer (APC 1.35%, 95% CI 1.08\u20131.62%).Conclusions: The burden of ALD is substantial and continues to rise in the US, with a particularly notable increase among females. Mortality from alcohol-attributable cancers is also increasing, mainly driven by primary liver cancer and pharyngeal cancer. However, system-wise, gastrointestinal cancer had the highest death attributable to alcohol. These findings highlight the urgent need for public health strategies to tackle ALD, primary liver cancer, and alcoholattributable extrahepatic malignancies.<\/jats:p>","DOI":"10.3350\/cmh.2025.0169","type":"journal-article","created":{"date-parts":[[2025,4,11]],"date-time":"2025-04-11T04:09:00Z","timestamp":1744344540000},"page":"1058-1070","update-policy":"https:\/\/doi.org\/10.3350\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Sex disparities in alcohol-associated liver disease and subtype differences in alcohol-attributable cancers in the United States"],"prefix":"10.3350","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9121-165X","authenticated-orcid":true,"given":"Pojsakorn","family":"Danpanichkul","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanfang","family":"Pang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanuj","family":"Mahendru","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Primrose","family":"Tothanarungroj","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis Antonio","family":"D\u00edaz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Pablo","family":"Arab","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pimtawan","family":"Jatupornpakdee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark D.","family":"Muthiah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kwanjit","family":"Duangsonk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Won-Mook","family":"Choi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel Q.","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donghee","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mazen","family":"Noureddin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karn","family":"Wijarnpreecha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suthat","family":"Liangpunsakul","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit G.","family":"Singal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7834-9825","authenticated-orcid":true,"given":"Ju Dong","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1902","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(09)60746-7"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2018.12.021"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2017.2161"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1016\/s2468-2667(19)30231-2"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1038\/s41575-022-00688-6"},{"key":"ref6","volume-title":""},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000002405"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1016\/j.cld.2021.03.009"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1093\/alcalc\/agac013"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.3390\/nu13093173"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.epi-22-0420"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2014.12.016"},{"key":"ref13","first-page":"1204","volume-title":"Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019","year":"2020"},{"key":"ref14","first-page":"2100","volume-title":"Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021","year":"2024"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1097\/meg.0000000000002882"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.34111"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1111\/apt.18101"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1111\/liv.70001"},{"key":"ref19","first-page":"813","volume-title":"Global, regional, and national prevalence of adult overweight and obesity, 1990-2021, with forecasts to 2050: a forecasting study for the Global Burden of Disease Study 2021","year":"2025"},{"key":"ref20","first-page":"785","volume-title":"Global, regional, and national prevalence of child and adolescent overweight and obesity, 1990-2021, with forecasts to 2050: a forecasting study for the Global Burden of Disease Study 2021","year":"2025"},{"key":"ref21","first-page":"2337","volume-title":"Spatial, temporal, and demographic patterns in prevalence of smoking tobacco use and attributable disease burden in 204 countries and territories, 1990-2019: a systematic analysis from the Global Burden of Disease Study 2019","year":"2021"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2022.879890"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1097\/hep.0000000000001260"},{"key":"ref24","first-page":"2145","volume-title":"Global trends and the impact of chronic hepatitis B and C on disability-adjusted life years","author":"Veracruz","year":"2022"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1111\/acer.15335"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2022-065425"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1016\/j.cld.2013.09.006"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanepe.2022.100325"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1007\/s40471-016-0068-6"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.1037\/adb0000143"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.1002\/hec.4866"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhealeco.2015.07.003"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.1002\/hep.32016"},{"key":"ref34","doi-asserted-by":"publisher","DOI":"10.15288\/jsad.2020.81.58"},{"key":"ref35","doi-asserted-by":"publisher","DOI":"10.1111\/apt.18473"},{"key":"ref36","first-page":"1098","volume-title":"Examining the evolving landscape of liver cancer burden in the United States from 1990 to 2019","author":"Al Ta\u2019ani","year":"2024"},{"key":"ref37","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2022.07.020"},{"key":"ref38","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2020.11.016"},{"key":"ref39","doi-asserted-by":"publisher","DOI":"10.1002\/hep.31583"},{"key":"ref40","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2020.11.042"},{"key":"ref41","doi-asserted-by":"publisher","DOI":"10.1200\/op.23.00810"},{"key":"ref42","doi-asserted-by":"publisher","DOI":"10.1111\/apt.16461"},{"key":"ref43","doi-asserted-by":"publisher","DOI":"10.1111\/liv.15277"},{"key":"ref44","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000002642"},{"key":"ref45","doi-asserted-by":"publisher","DOI":"10.1111\/liv.15933"},{"key":"ref46","doi-asserted-by":"publisher","DOI":"10.1111\/acer.13944"},{"key":"ref47","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000000442"},{"key":"ref48","doi-asserted-by":"publisher","DOI":"10.35946\/arcr.v40.2.01"},{"key":"ref49","doi-asserted-by":"publisher","DOI":"10.7205\/milmed-d-09-00080"},{"key":"ref50","first-page":"1883","volume-title":"Epidemic within a pandemic: Alcohol-associated hepatitis and COVID-19","author":"Marlowe","year":"2023"},{"key":"ref51","doi-asserted-by":"publisher","DOI":"10.1016\/j.cld.2012.08.011"},{"key":"ref52","doi-asserted-by":"publisher","DOI":"10.7326\/m23-0518"},{"key":"ref53","doi-asserted-by":"publisher","DOI":"10.2147\/jhc.s467913"},{"key":"ref54","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djac097"},{"key":"ref55","doi-asserted-by":"publisher","DOI":"10.1097\/cld.0000000000000192"},{"key":"ref56","doi-asserted-by":"publisher","DOI":"10.1056\/nejmsr2306723"},{"key":"ref57","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2023.11.006"},{"key":"ref58","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2023-330771"},{"key":"ref59","doi-asserted-by":"publisher","DOI":"10.1016\/j.metabol.2023.155744"},{"key":"ref60","doi-asserted-by":"publisher","DOI":"10.1038\/s41575-023-00822-y"},{"key":"ref61","doi-asserted-by":"publisher","DOI":"10.1002\/hep.31042"},{"key":"ref62","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.k2817"},{"key":"ref63","doi-asserted-by":"publisher","DOI":"10.1097\/hc9.0000000000000409"},{"key":"ref64","doi-asserted-by":"publisher","DOI":"10.1111\/liv.16023"},{"key":"ref65","doi-asserted-by":"publisher","DOI":"10.1016\/j.ogc.2016.10.001"}],"container-title":["Clinical and Molecular Hepatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/e-cmh.org\/upload\/pdf\/cmh-2025-0169.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/e-cmh.org\/journal\/view.php?doi=10.3350\/cmh.2025.0169","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/e-cmh.org\/upload\/pdf\/cmh-2025-0169.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T05:47:57Z","timestamp":1765259277000},"score":1,"resource":{"primary":{"URL":"http:\/\/e-cmh.org\/journal\/view.php?doi=10.3350\/cmh.2025.0169"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,1]]},"references-count":65,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,7]]}},"URL":"https:\/\/doi.org\/10.3350\/cmh.2025.0169","relation":{},"ISSN":["2287-2728","2287-285X"],"issn-type":[{"value":"2287-2728","type":"print"},{"value":"2287-285X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,1]]},"assertion":[{"value":"2025-02-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-04-08","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-04-11","order":2,"name":"published","label":"Published online","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-01","order":3,"name":"published","label":"Print publication","group":{"name":"publication_history","label":"Publication History"}}]}}