Mortality from liver disease has increased over the last decade in the US. Alcohol is a known cause, but its use also contributes to the development or progression of other types of liver disease, complicating efforts to quantify the overall impact of alcohol use on liver disease. Researchers developed causal and statistical models based on a narrative review of the literature to assess the relationships between alcohol use and the development or progression of various liver diseases in the US in 2017, including through alcohol’s interactions with other relevant behavior-related risk factors.
- Alcohol use caused 54,500 incident cases of liver cirrhosis, of which approximately 35% were from diseases other than alcohol-associated cirrhosis.
- Through interaction with behavioral risk factors, alcohol use accounted for the progression to cirrhosis of 10,400 cases of obesity-related liver disease and 7700 cases of hepatitis C virus.
- Alcohol use caused 47,300 total deaths from liver disease, including 6600 from liver cancer.
Comments: Accounting for alcohol’s role in liver diseases that are exacerbated by alcohol consumption or caused by alcohol-associated risk factors yields substantially higher estimates of morbidity and mortality than those based on diseases for which alcohol is the original or principal cause. This has important implications for public health surveillance, and serves as a reminder to clinicians about the role of alcohol in a wide range of liver diseases.
Timothy S. Naimi, MD, MPH