Global and regional economic burden of alcohol-attributable cancers: A benchmarking analysis.

Abstract

e23105 Background: Alcohol consumption is responsible for 6–8% of global cancer deaths, but comprehensive regional economic estimates are lacking. We quantified direct and indirect economic burdens of alcohol-related cancers worldwide using GBD 2023 data. Methods: Alcohol-attributable cancer burden was assessed for all cancer types across 189 countries using the GBD 2023 comparative risk assessment framework. Major sites included colorectal (30.8% of total alcohol-related cases), liver (28.4%), breast (18.7%), and esophageal (14.6%). Population-attributable fractions (PAF) were derived from pooled estimates of 2,281 epidemiologic studies. Direct medical costs encompassed diagnostics, chemotherapy, radiotherapy, surgery, and palliative care; indirect costs included productivity losses from premature mortality and morbidity. Expenditures were adjusted by regional GDP per capita. Results: In 2023, alcohol-related cancers caused 842,000 deaths globally (8.1% of all cancer mortality), resulting in 18,400,000 DALYs. Total annual direct medical costs were $156 billion USD, while indirect costs from lost productivity and informal care reached $198 billion USD. Liver cancer imposed the greatest annual direct economic burden ($67.4 billion), followed by colorectal ($52.1 billion), breast ($23.8 billion), and esophageal cancer ($21.4 billion). Low- and middle-income countries (LMICs) accounted for 61% of global alcohol-related cancer deaths but received only 28% of direct healthcare expenditures. In contrast, high-income countries spent an average of $89,400 per patient versus $6,200 in low-income settings. Between 2000 and 2023, alcohol-attributable cancer burden rose by 54% globally, surpassing the growth in all-cancer burden (37%). Countries with active alcohol reduction policies (e.g., Australia, Canada, Nordic countries) exhibited 8–12% lower incidence of alcohol-attributable cancers compared to those without such policies. Regional mortality hotspots were identified in Eastern Europe and Southern Africa, where alcohol-related cancers comprised 18–24% of all cancer deaths. Modeling suggests that implementing alcohol taxation and expanding treatment access in LMICs could prevent approximately 184,000 alcohol-related cancer deaths annually. Conclusions: Alcohol-related cancers are responsible for over $350 billion USD in annual global economic losses, with a rapidly rising burden in LMICs and pronounced treatment disparities. Policy-based reductions in harmful alcohol use are urgently needed to mitigate preventable deaths and improve global cancer control.