Abstract
BACKGROUND: Chronic liver disease (CLD) and liver cancer (LC) pose significant global health challenges affecting millions of people worldwide. An etiology-region-time specific understanding of their global burden is necessary. METHODS: This study utilized data from the 2021 Global Burden of Disease Study, encompassing incidence, prevalence, mortality, and Disability-Adjusted Life Years (DALYs) attributed to CLD and LC. RESULTS: In 2021, global deaths from CLD and LC were 1,425 thousand and 483 thousand, respectively, with a decline in age-standardized death rates (ASDR) by 31.9% and 3.7% from 1990 to 2021. By categorizing the 21 regions into alcohol-dominant (Region A, 39 countries), HBV-dominant (Region B, 60 countries), and HCV-dominant (Region C, 33 countries), distinct health inequities emerged. In Region A, Romania and Ukraine face rising incidence and mortality rates due to alcohol-induced liver disease. In Region B, HBV-related rates are high in Nigeria and Mali, while China has reduced. Region C, including the Central African Republic and Libya, shows high HCV-induced rates, highlighting regional disparities. The incidence and mortality rates of CLD are negatively correlated with the Human Development Index (HDI), with varying regional trends. In Region A, health inequities have narrowed, while they have intensified in Regions B and C. Significant health inequities exist, with CB and CC burdens more concentrated in high-HDI countries where inequities are diminishing, whereas CA burdens are predominantly in low-HDI countries, where inequities are more pronounced. CONCLUSION: These findings highlight the urgent need to address health inequities in liver disease burden across specific regions.