Mortality Risk According to Changes in Alcohol Consumption Post‐Diagnosis Among Liver Cancer Patients

ABSTRACT Background and Aims Excess alcohol consumption causes liver cancer; however, its change effects on patient survival remain unclear. This study evaluated associations between alcohol consumption changes post‐diagnosis and mortality risk in liver cancer survivors. Methods The study included 16 637 patients, who were diagnosed with liver cancer between 2002 and 2017 and followed up until 2019, using the Korean National Health Insurance Service Database. Alcohol consumption levels were measured at pre‐ and post‐diagnosis, and their associations with mortality risks were assessed with Cox proportional hazard models. Results Drinkers accounted for 54.46% and 9.39% of men and women, respectively, before diagnosis, and 14.70% and 2.34% after diagnosis. Compared with persistent non‐current drinkers in men, post‐diagnosis drinking at any pre‐diagnosis intake level was associated with 25%–67% increased risks of all‐cause mortality. Adjusted hazard ratios (95% confidence intervals) were 1.59 (1.24, 2.03) for non‐current/heavy drinkers (i.e., transitioned from non‐current to heavy drinking post‐diagnosis), 1.54 (1.26, 1.88) for light‐to‐moderate/heavy drinkers, and 1.67 (1.45, 1.92) for heavy/heavy drinkers. No significant association was observed among women. Compared with persistent drinkers, quitting among men presented lower risks in light‐to‐moderate (0.80 [0.70, 0.91]) and heavy drinkers (0.61 [0.53, 0.71]). Quitting was beneficial even among heavy drinkers at advanced stages (0.47 [0.24, 0.92] and 0.50 [0.25, 0.99] for all‐cancer and liver cancer mortalities, respectively). Conclusions Post‐diagnosis alcohol consumption is associated with increased mortality risks in liver cancer survivors, particularly men, with more pronounced effects than pre‐diagnosis behaviour. Alcohol cessation benefits patient prognosis, even for heavy drinkers with advanced‐stage liver cancer.