Global Epidemiology of Cirrhosis in Women

Abstract

Recent epidemiological evidence indicates a significant rise in cirrhosis burden over the past two decades in all parts of the world, with cirrhosis incidence rates and related deaths escalating quickly. Women face unique risk factors and susceptibility to chronic liver diseases compared to men, underscoring the need for a sex-specific approach in early identification, reversal of causative factors, and complications prevention. This review aims to explore epidemiological trends and sex-specific factors contributing to the global epidemiology of cirrhosis among females today. While cirrhosis prevalence remains higher in males globally, the incidence rate from 2010 to 2019 grew faster among females. The female-to-male incidence ratio of metabolic-associated steatotic liver disease (MASLD) related cirrhosis globally in 2019 was 1.3, indicating a shifting trend towards new diagnoses among women now surpassing that of men. Alcohol-associated cirrhosis (AC) epidemiology is also changing, with trends towards equal incidence of AC between both sexes, particularly in industrialized nations with increased alcohol accessibility. Cirrhosis from viral hepatitis remains the main etiology among females in endemic regions. Sex differences in epidemiology are likely multifactorial, influenced by varying risk factors, susceptibility and behaviors between sexes. Further research is necessary to better understand these disparities and to tailor sex-specific interventions towards improved management and treatment strategies, ultimately enhancing outcomes for women with cirrhosis and providing better patient-centered care.