Nationwide analysis and trend of liver cancer mortality attributable to drug use in United States from 1991 to 2021.

Abstract

10565 Background: Liver cancer attributable to drug use represents an escalating public health concern in the United States (US). This study analyzes mortality, and related metrics for liver cancer attributed to drug use from 1991 to 2021, focusing on national and state-level trends and examining gender disparities and geographic variations with projections of Age-standardized mortality rates (ASMR) extending to 2040. Methods: The Global Burden of Disease (GBD) 2021 database was used to extract age-standardized mortality rate (ASMR) and disability-adjusted life years (DALY) for liver cancer mortality attributable to drug use in the United States from 1991 to 2021. Mortality data were stratified by gender, year, and region. Joinpoint regression analysis was performed to further evaluate trends and Annual Percent Change (APC) was calculated. Time series regression was used to calculate projected ASMR in 2040. Results: From 1991 - 2021, the ASMR for liver cancer attributable to drug use in the U.S. increased nearly threefold, from 0.54 per 100,000 (95% CI: 0.44–0.65) to 1.60 per 100,000 ( APC:6.51%, 95% CI: 1.35–1.84). The DALY rate rose significantly from 15.22 per 100,000 to 39.36 per 100,000, highlighting the growing burden. Gender analysis revealed higher ASMRs in males, increasing from 0.74 to 2.12 per 100,000, compared to 0.38 to 1.14 per 100,000 in females, with APC of 6.25% and 6.55%, respectively. A state-level analysis of ASMR in 2021 showed the highest ASMR in California (2.27), followed by the District of Columbia (2.11), and Michigan (1.93). Meanwhile, Nebraska (0.73) had the lowest ASMR in 2021, followed by Iowa (0.91) and New York (1.15 ). The highest annual percent change (APC) was 11.47% in Nebraska, while the lowest was 3.58% in the District of Columbia. The Joinpoint regression analysis identifies five distinct periods of varying Annual Percent Changes (APC) in liver cancer mortality attributable to drug use. From 1991 to 2001, there was a sharp increase in mortality (APC = 5.75%), followed by slow growth between 2001-2007 (APC = 2.86%). However, from 2007-2010, there was a reacceleration (APC = 4.63%). Between 2010 - 2016, the growth rate decreased further (APC = 2.67%), after which 2016 - 2021, mortality rates stabilized (APC = 0.58%). The forecasted national ASMR for 2040 is estimated to be approximately 2.38 per 100,000. Conclusions: This study underscores a substantial rise in liver cancer mortality attributable to drug use in the United States from 1991 to 2021, with notable gender and geographic disparities. Projected increases in ASMR, coupled with observed trend shifts, emphasize the urgent need for targeted prevention and intervention strategies to mitigate the growing burden of drug use-related liver cancer.