Liver cirrhosis mortality in 15 European countries: Differences and trends during the post-war period

Abstract

Mats Ramstedt: Liver cirrhosis mortality in 15 European countries – differences and trends during the post-war period The aim of this paper was to describe and analyse differences and trends in liver cirrhosis mortality rates during the post-war era in 15 European countries. The study countries include all EU member states (except Luxembourg) and Norway. Liver cirrhosis mortality data and population figures were gathered from the WHO Mortality Database. The rank order of these countries, with respect to cirrhosis rates, were in general stable during the post-war period and most countries had increasing cirrhosis rates until the 1970s and then declining rates. This general picture was true also when sex-specific rates were studied. A deviant case was Sweden, with an exceptionally sharp increase from 1950 until the 1970s. Other deviant cases were Denmark, Finland and the UK, where cirrhosis mortality has not declined since the 1970s. Age specific analyses revealed that in one group of countries, mortality trends seem to be collective with respect to age, while in another cluster, different age groups exhibited divergent trends. Furthermore, the age-profile of cirrhosis mortality varies considerably between the study countries. Cross-country analyses were performed to elucidate the influence of some plausible determinants of cirrhosis mortality. According to the outcome, there was a fairly close relationship between cirrhosis mortality, on the one hand, and per capita alcohol consumption, alcohol prices, and the restrictiveness of alcohol policy, on the other. More detailed analyses based on time series data are needed to test how these variables are interrelated.