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Cited by 181Alcohol Consumption and Health EffectsSubstance Abuse Treatment and OutcomesHealthcare Systems and Public Health

Liver Cirrhosis Mortality in Europe, with Special Attention to Central and Eastern Europe

Zatoński, Witold A., Sulkowska, Urszula, Mańczuk, Marta, Rehm, Jürgen, Boffetta, Paolo, Lowenfels, Albert B., La Vecchia, Carlo·2010·European Addiction Research
DOI 10.1159/000317248
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Abstract

Background and Aims: Over the last decades, Europe has experienced dramatic changes in the geographical variation of liver cirrhosis rates. We attempt to provide a comprehensive analysis of patterns and trends in liver cirrhosis mortality in European countries and regions. Methods: Age-standardized (world standard) liver cirrhosis mortality rates per 100,000 person-years at ages 20–64 for 35 separate countries were computed using the World Health Organization Mortality Database. Results: In the analyzed period (1959–2002), a very strong East-to-West gradient in mortality rates was observed. An increase of the burden of mortality due to liver cirrhosis appeared in Eastern Europe in two specific areas: South-eastern Europe and North-eastern Europe. In the first group of countries, liver cirrhosis mortality was 10–20 times higher than in most other European states, levels never before observed in Europe. In the countries of North-eastern Europe (former Soviet Union countries) liver cirrhosis mortality was characterized by dramatic changes (both positive and negative) in specific periods of time. Conclusions: Despite the fact that the etiology of liver cirrhosis is multifactorial, it seems that alcohol drinking is the factor that best explains the observed patterns in frequency of this disease in Europe. Alcohol control policies in Central and Eastern Europe could lead to an appreciable reduction of premature mortality from liver cirrhosis.

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Crossref · 10.1159/000317248

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  • In Europe, age-standardized liver cirrhosis mortality rates and time trends followed a strong East-to-West gradient.

    “Age-standardized liver cirrhosis mortality rates and time trends in Europe followed a strong ‘East-to-West gradient’, as previously identified by Zatonski et al. [5] (Figure 4).”

    From Liver cirrhosis mortality in 187 countries between 1980 and 2010: a systematic analysis (2014) · cites this paper as [5]

  • Since the 1970s, improvements in alcohol quality and a reduction in alcohol consumption have been the major determinants of the steady decline in cirrhosis mortality in Western European countries.

    “Since the 1970s, improvements in alcohol quality and a reduction in alcohol consumption have been the major determinants of the steady decline in cirrhosis mortality in these countries [5,36–39].”

    From Liver cirrhosis mortality in 187 countries between 1980 and 2010: a systematic analysis (2014) · cites this paper as [5]

  • During the late 1980s and early 1990s, a dramatic increase in alcohol consumption, much of which was of poor quality and hepatotoxic, followed the removal of restrictions on the alcohol trade, particularly in Russia and Ukraine.

    “During this period, a dramatic increase in alcohol consumption, much of which was of poor quality and hepatotoxic, followed the removal of restrictions on the alcohol trade, particularly in Russia and Ukraine [5,48–50].”

    From Liver cirrhosis mortality in 187 countries between 1980 and 2010: a systematic analysis (2014) · cites this paper as [5]

  • The high liver cirrhosis death rates in Moldova and Hungary may be largely attributable to widespread consumption of highly hepatotoxic home-brewed fruit-based alcoholic beverages in these countries.

    “This may be largely attributable to widespread consumption of highly hepatotoxic home-brewed fruit-based alcoholic beverages in these countries [5,36–39,52–54].”

    From Liver cirrhosis mortality in 187 countries between 1980 and 2010: a systematic analysis (2014) · cites this paper as [5]

  • The decline in liver cirrhosis mortality in Western Europe, particularly Spain, France and Italy, is due to a steady decrease in alcohol consumption, accompanied by improvement in wine quality and restrictions on home-brewed alcoholic beverage making.

    “The decline in liver cirrhosis mortality in Western Europe, particularly in Spain, France and Italy, is undoubtedly due to a steady decrease in alcohol consumption, accompanied by an improvement in the quality of wine and restrictions on home-brewed alcoholic beverage making [5,36–39].”

    From Liver cirrhosis mortality in 187 countries between 1980 and 2010: a systematic analysis (2014) · cites this paper as [5]

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Authors
Zatoński, W. A., Sulkowska, U., Mańczuk, M., Rehm, J., Boffetta, P., Lowenfels, A. B., & La Vecchia, C.
Affiliations
  • The Maria Sklodowska-Curie National Research Institute of Oncology (PL)
  • Icahn School of Medicine at Mount Sinai (US)
  • New York Medical College (US)
ORCID
Venue
European Addiction Research
Publisher
S. Karger AG
Published
2010
Volume
16
Issue
4
Pages
193-201
ISSN
  • 1022-6877 (ISSN-L)
  • 1421-9891
DOI
10.1159/000317248
OpenAlex
W2036374651
Cited by
181
References
37
Citations by year
2026: 3 · 2025: 3 · 2024: 3 · 2023: 4 · 2022: 6 · 2021: 12 · 2020: 15 · 2019: 26 · 2018: 8 · 2017: 19 · 2016: 16 · 2015: 20 · 2014: 14 · 2013: 12 · 2012: 10
FWCI
6.93
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • European Addiction Research (publishedVersion)
  • PubMed (publishedVersion)
  • HAL (submittedVersion)
  • Archivio istituzionale della ricerca (Alma Mater Studiorum Università di Bologna) (submittedVersion)
Funders
  • World Health Organization
  • European Commission
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
liver cirrhosis, cirrhosis mortality, mortality trends, Central and Eastern Europe, former Soviet Union, alcohol consumption, alcohol policy, premature mortality, Southeastern Europe, Northeastern Europe
MeSH terms
Adult, Alcohol Drinking, Europe, Female, Humans, Liver Cirrhosis, Male, Middle Aged, Risk Factors, Age Distribution

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