Global alcohol-attributable liver cancer mortality appears to have shifted direction during the COVID-19 pandemic, reversing a previous decline and rising between 2020 and 2023, according to a new analysis based on Global Burden of Disease 2023 data. The study, published in npj Science of Food and reported by News-Medical, examined trends across 204 countries and territories from 1990 to 2023.
Researchers found that while mortality linked to alcohol-attributable cirrhosis, alcoholic cardiomyopathy and alcohol use disorders declined over the full study period, alcohol-attributable liver cancer mortality increased slightly overall. The analysis also identified a clear inflection point during the pandemic years, when liver cancer mortality shifted from a pre-pandemic decline to an increase.
Why the reversal matters for public health
The authors said the findings highlight an urgent need for disease-specific surveillance and stronger cancer screening pathways, alongside interventions that address alcohol-related harm and sex-specific vulnerabilities. They suggested that disruptions in cancer screening, diagnostic delays, treatment delays and altered drinking habits may all have played a role in the reversal.
However, the study also cautioned against drawing direct causal conclusions. Because liver cancer usually develops over decades, the researchers said pandemic-related changes in alcohol consumption alone were unlikely to fully explain the mortality shift seen by 2023. The analysis was ecological and model-based, meaning it could not establish cause and effect at the individual level.
Women showed a sharper change in trajectory
The paper also projected that by 2050, global liver cancer mortality would rise to 3.02 deaths per 100,000 in men and 0.98 in women. While the absolute rate would remain higher in men, the relative increase was projected to be greater among women. During 2020 to 2023, liver cancer mortality increased by an estimated 2.73% per year among females and 1.47% among males.
In total, the GBD estimates showed 637,780 alcohol-attributable deaths across the four conditions analysed in 2023, including deaths from cirrhosis, alcohol use disorders, liver cancer and alcoholic cardiomyopathy. The authors said the pattern varies widely by geography and context, underscoring the need for closer monitoring of alcohol-related disease burden in the years ahead.
For health services and policy makers, the message is clear: even as some alcohol-linked conditions continued long-term declines, liver cancer emerged as a worrying exception during the pandemic period. The study adds to growing evidence that delays in diagnosis and treatment can have lasting effects well beyond the immediate disruption that caused them.
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