Chronic Liver Disease and American Indians/Alaska Natives

Among American Indians and Alaska Natives, chronic liver disease is a leading cause of death. While the cause is not always known, some cases can be initiated by conditions such as alcohol use disorder, obesity, and exposure to hepatitis B and C viruses.

• In 2022, chronic liver disease was the second leading cause of death for non-Hispanic American Indians/Alaska Natives ages 25-54.¹
• In 2018, American Indian/Alaska Native adults were 1.6 times more likely to be diagnosed with chronic liver disease than non-Hispanic white adults.²
• In 2021,³
  • American Indian/Alaska Native males were 3.4 times more likely to die of chronic liver disease or cirrhosis than non-Hispanic white males.
  • American Indian/Alaska Native females were 4.5 times more likely to die from chronic liver disease or cirrhosis than non-Hispanic white females.

Cancer Rates (2017–2021)

Cancer incidence in males, age-adjusted rate per 100,000 population, 2017–2021
Cancer	Non-Hispanic American Indian/Alaska Native Males	Non-Hispanic White Males	Non-Hispanic American Indian/Alaska Native / Non-Hispanic White Ratio
All Sites	442.2	510.7	0.9
Liver & IBD	25.1	11.2	2.2

Cancer incidence in females, age-adjusted rate per 100,000 population, 2017–2021
Cancer	Non-Hispanic American Indian/Alaska Native Females	Non-Hispanic White Females	Non-Hispanic American Indian/Alaska Native / Non-Hispanic White Ratio
All Sites	421.1	447.0	0.9
Liver & IBD	11.5	4.3	2.7

Diagnosed

Adults age 18 and over who have been told by a doctor that they have chronic liver disease, age-adjusted percentage, 2018
American Indian/Alaska Native	Non-Hispanic White	American Indian/Alaska Native / Non-Hispanic White Ratio
2.5	1.6	1.6

Death Rates

Cancer mortality in males, age-adjusted rate per 100,000 population, 2018–2022
Cancer	Non-Hispanic American Indian/Alaska Native Males	Non-Hispanic White Males	Non-Hispanic American Indian/Alaska Native / Non-Hispanic White Ratio
All Sites	185.8	179.0	1.0
Liver & IBD	16.7	8.4	2.0

Cancer mortality in females, age-adjusted rate per 100,000 population, 2018–2022
Cancer	Non-Hispanic American Indian/Alaska Native Females	Non-Hispanic White Females	Non-Hispanic American Indian/Alaska Native / Non-Hispanic White Ratio
All Sites	140.9	131.0	1.1
Liver & IBD	8.7	3.8	2.3

Chronic Liver Disease and Cirrhosis mortality, age-adjusted rates per 100,000 population, 2021
	Non-Hispanic American Indian/Alaska Native	Non-Hispanic White	Non-Hispanic American Indian/Alaska Native / Non-Hispanic White Ratio
Male	86.7	25.4	3.4
Female	68.4	15.1	4.5
Both Sexes	77.4	20.2	3.8

---

¹CDC. WISQARS. Leading Causes of Death. (back)

²CDC, 2020. Summary Health Statistics: National Health Interview Survey: 2018. Table A-4a. (back)

³CDC, 2024. Deaths: Final Data for 2021. National Vital Statistics Report, Vol. 73, No. 8. Table 10. (back)