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Trends of liver cirrhosis mortality in Europe, 1970-1989: age-period-cohort analysis and changing alcohol consumption.

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Corrao, G., Ferrari, P., Zambon, A., Torchio, P., Arico, S., Decarli, A.·1997·International Journal of Epidemiology
DOI 10.1093/ije/26.1.100
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Abstract

BACKGROUND: Since the mid 1970s, a striking reduction in alcohol-related problems has been observed in many Western countries. Liver cirrhosis mortality is considered to be a major indicator of alcohol-related problems in the general population. The aim of the present study is to describe liver cirrhosis mortality trends in European countries between 1970 and 1989. METHODS: This is a descriptive study on liver cirrhosis mortality in 25 European countries, and in four grouped European regions. A Poisson log-linear age-period-cohort model is used to clarify whether the recent trend in mortality represents a short-term fluctuation or an emerging long-term trend. In addition, a descriptive comparison between trends in per capital alcohol consumption and liver cirrhosis mortality is conducted. RESULTS: In the whole European population and in that of Western and Southern Europe increasing period effects were observed until the second half of the 1970s followed by a decline in the next periods. In Eastern Europe the decline in period effects started in the first half of the 1980s, whereas in Northern Europe an increasing period effect was observed until the second half of the 1970s, followed by a stabilization. Similar trends were observed for per capita alcohol consumption. The age effect analysis showed a continuously rising effect in Eastern Europe, whereas an attenuation of the effect at around age 65 years was observed in Western Europe. Intermediate patterns were observed in Southern and Northern Europe. The birth cohort effect suggested that in the Western and Southern populations mortality could continue to decrease over the next decade, while in Eastern and Northern mortality is still rising and this will probably continue for the next decade. CONCLUSIONS: The age-period-cohort analysis allows targeting of health care and prevention programmes based on future trends. Aetiological and prognostic factors act differently in Europe. A better understanding of the trends would require more detailed information on alcoholism treatment rates, alcohol habits, viral hepatitic infections and other factors involved in the aetiopathogenesis of the disease.

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  • The comparatively short lag between national alcohol consumption levels and changes in cirrhosis mortality is probably related to the effects of alcohol on patients with subclinical compensated liver cirrhosis.

    “While alcohol generally requires several years to induce fibrosis in the liver, the comparatively short lag between national alcohol consumption levels and changes in cirrhosis mortality is probably related to the effects of alcohol on patients with subclinical compensated liver cirrhosis [4,38,51].”

    From Liver cirrhosis mortality in 187 countries between 1980 and 2010: a systematic analysis (2014) · cites this paper as [4]

  • Preventive measures such as screening transfused blood for viral hepatitis, employing appropriate medical hygiene in health facilities, introducing hepatitis B vaccination programs, imposing alcohol trade restrictions and raising taxes on alcohol, and implementing health promotion and education programs to reduce alcohol consumption and harmful alcohol use are relatively inexpensive and cost-ef

    “By contrast, preventive measures such as screening transfused blood for viral hepatitis, employing appropriate medical hygiene in health facilities, introducing hepatitis B vaccination programs, imposing alcohol trade restrictions and raising taxes on alcohol, implementing health promotion and education programs to reduce alcohol consumption and harmful alcohol use are relatively inexpensive and”

    From Liver cirrhosis mortality in 187 countries between 1980 and 2010: a systematic analysis (2014) · cites this paper as [4]

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Research works printed but not linked: 14

  1. Grant B F, Noble J, Malin H. Decline in liver cirrhosis mortality and components of change: United States 1973-1983. Alcohol Hlth Res Word 1986; 10: 66-69.
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  9. Robertson J. Safe drinking. Br Med J 1994; 308: 346.
  10. Aricó S, Galatola G, Tabone M et al. The measure of lifetime alcohol consumption in cirrhotic patients: reproducibility and clinical relevance. Liver 1995; 15: 202-08.
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  13. Mele A, Stazi M A, Corona R et al. Decline of incidence of A, B and NonA-NonB hepatitis in Italy. Results of four years surveillance. It J Gastroenterol 1990, 22: 274-80.
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Authors
Corrao, G., Ferrari, P., Zambon, A., Torchio, P., Arico, S., & Decarli, A.
Affiliations
  • University of Milan (IT)
  • Fondazione IRCCS Istituto Nazionale dei Tumori (IT)
ORCID
Venue
International Journal of Epidemiology
Publisher
Oxford University Press (OUP)
Published
1997-02-01
Volume
26
Issue
1
Pages
100-109
ISSN
  • 0300-5771 (ISSN-L)
  • 1464-3685
DOI
10.1093/ije/26.1.100
OpenAlex
W2131362825
Cited by
91
References
45
Citations by year
2025: 3 · 2023: 1 · 2022: 2 · 2020: 1 · 2019: 2 · 2018: 2 · 2017: 2 · 2016: 4 · 2015: 4 · 2014: 4 · 2013: 3 · 2012: 5
FWCI
2.67
Type
journal article
Language
en
Open access
Locations
  • International Journal of Epidemiology (publishedVersion)
  • PubMed (publishedVersion)
  • Archivio Istituzionale della Ricerca (Universita Degli Studi Di Milano) (submittedVersion, other-oa)
  • BOA (University of Milano-Bicocca) (submittedVersion)
Topics
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Health Sciences › Medicine › Epidemiology › Healthcare Systems and Public Health
Keywords
cirrhosis mortality, alcohol consumption, alcohol-related mortality, mortality trends, age-period-cohort analysis, birth cohort effects, period effects, alcoholism, Europe, Eastern Europe, Western Europe, Southern Europe, Northern Europe
MeSH terms
Adult, Aged, Alcohol Drinking, Europe, Europe, Eastern, Female, Humans, Liver Cirrhosis, Alcoholic, Male, Middle Aged, Risk Factors, Cohort Studies, Incidence, Survival Rate, Linear Models, Age Distribution, Sex Distribution

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