Rising Mortality From Chronic Liver Disease in Young US Adults: A Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER)-Based Analysis

TL;DR

Chronic liver disease is causing more deaths in young US adults, especially among men and certain racial groups, highlighting the need for better prevention and care.

Contribution

This study reveals rising mortality from chronic liver disease in young US adults and identifies significant racial disparities.

Findings

CLD mortality increased in all age and sex subgroups from 2000 to 2020.

AI/AN men aged 35-44 had the highest CLD mortality rates.

Racial disparities in CLD mortality were statistically significant across all groups.

Abstract

Background: Chronic liver disease (CLD), traditionally considered a condition of older adults, has shown increasing mortality in younger US adults. Rising rates of alcohol-related liver disease and metabolic dysfunction-associated steatotic liver disease (MASLD) have shifted the demographic profile of CLD burden.

Objective: This study aimed to identify significant trends and disparities in CLD mortality among US adults aged 25-44 years from 2000 to 2020, with analysis stratified by age subgroup, sex, and race/ethnicity.

Materials and methods: We conducted a retrospective analysis using the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) Underlying Cause of Death database. Deaths attributed to CLD were identified using International Classification of Diseases 10th Revision (ICD-10) codes K70 (alcoholic liver disease), K73 (chronic hepatitis), and K74 (fibrosis and cirrhosis). Data were stratified by age (25-34 and 35-44), sex, and race. Crude death rates per 100,000 were calculated. One-way analysis of variance (ANOVA) was performed to evaluate racial disparities within subgroups.

Results: CLD mortality increased in all subgroups from 2000 to 2020. The highest rates were observed among men aged 35-44, particularly American Indian or Alaska Native (AI/AN) men, who reached an average of 19.4 deaths per 100,000. Black men and Hispanic women also experienced significant increases. ANOVA confirmed statistically significant racial disparities (p<0.0001) within all sex and age groups.

Conclusion: CLD mortality is rising among young US adults, with disproportionately high rates in AI/AN and Black populations. These findings underscore the need for earlier screening, expanded public health interventions, and targeted support for underserved communities.

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