ORIGINAL RESEARCH article
Front. Oncol.
Sec. Gastrointestinal Cancers: Hepato Pancreatic Biliary Cancers
This article is part of the Research TopicChallenges and Innovations in Healthcare Management and Long-Term Care for an Aging SocietyView all 40 articles
Global and Regional Burden of Liver Cancer Attributable to Drug Use in Elderly Patients: A 1990-2021 Analysis from the GBD Study
Provisionally accepted
- Second Affiliated Hospital, Xuzhou Medical University, Xuzhou, China
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Background: The global burden of liver cancer is undergoing an etiological shift, driven by population aging and the increasing complexity of pharmacological management. While Drug-Induced Liver Injury (DILI) is a recognized carcinogenic mechanism, the population-level impact remains under-quantified. This study aims to quantify the spatiotemporal trends of liver cancer burden attributable to drug use in the elderly population (aged 55+) and elucidate the drivers behind regional disparities. Methods: Leveraging data from the Global Burden of Disease (GBD) Study 2021, we analyzed incidence, mortality, and disability-adjusted life years (DALYs) across 204 countries and territories from 1990 to 2021. Adopting the Comparative Risk Assessment (CRA) framework, we estimated the specific burden by calculating the Population Attributable Fraction (PAF) relative to a theoretical minimum risk exposure level (TMREL) of zero drug use. Temporal trends were assessed using Estimated Annual Percentage Change (EAPC), and associations with the Socio-demographic Index (SDI) were evaluated to delineate developmental disparities. Results: Globally, the absolute number of deaths has steadily increased despite stable age-standardized rates. A distinct "SDI Divergence" was observed: High-SDI regions exhibited the most rapid escalation in burden (highest EAPC), driven by the "Opioid-Polypharmacy Nexus," whereas Low-SDI regions sustained a persistently high baseline burden due to unmet diagnostic needs. Demographic analysis revealed a stark male predominance and identified the 55–74 age group as the "active intervention window," accounting for the largest proportion of the global burden in terms of both mortality and DALYs. Discussion: The escalating burden of liver cancer attributable to drug use in the elderly underscores the "Cumulative Impact of Prolonged Exposure," where the intersection of physiological aging and complex drug use patterns amplifies hepatic risk. Mitigating this crisis requires stratified strategies: prioritizing "Capacity Building" (integrating screening into infectious disease programs) in resource-limited settings, and implementing strict "Stewardship" (pharmacovigilance and active deprescribing) in developed nations to curb this trajectory.
Keywords: attributable burden, Disability-adjusted life years, Drug use, elderly population, Global burden of disease, liver cancer, Mortality
Received: 05 Aug 2025; Accepted: 27 Jan 2026.
Copyright: © 2026 Xia, Rong and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Baoqing Wang
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