TRENDS OF LIVER-CIRRHOSIS MORTALITY IN EUROPE, 1970-1989 - AGE-PERIOD-COHORT ANALYSIS AND CHANGING ALCOHOL-CONSUMPTION

Citation
G. Corrao et al., TRENDS OF LIVER-CIRRHOSIS MORTALITY IN EUROPE, 1970-1989 - AGE-PERIOD-COHORT ANALYSIS AND CHANGING ALCOHOL-CONSUMPTION, International journal of epidemiology, 26(1), 1997, pp. 100-109
Citations number
57
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Public, Environmental & Occupation Heath
ISSN journal
0300-5771
Volume
26
Issue
1
Year of publication
1997
Pages
100 - 109
Database
ISI
SICI code
0300-5771(1997)26:1<100:TOLMIE>2.0.ZU;2-P
Abstract
Background. Since the mid 1970s, a striking reduction in alcohol-relat ed problems has been observed in many Western countries. Liver cirrhos is 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 betwe en 1970 and 1989, Methods. This is a descriptive study on liver cirrho sis mortality in 25 European countries, and in four grouped European r egions. A Poisson log-linear age-period-cohort model is used to clarif y whether the recent trend in mortality represents a short-term fluctu ation or an emerging long-term trend. In addition, a descriptive compa rison between trends in per capita alcohol consumption and liver cirrh osis 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 197 0s, followed by a stabilization. Similar trends were observed for per capita alcohol consumption. The age effect analysis showed a continuou sly rising effect in Eastern Europe, whereas an attenuation of the eff ect at around age 65 years was observed in Western Europe, Intermediat e patterns were observed in Southern and Northern Europe. The birth co hort effect suggested that in the Western and Southern populations mor tality could continue to decrease over the next decade, while in Easte rn and Northern Europe mortality is still rising and this will probabl y continue for the next decade. Conclusions. The age-period-cohort ana lysis 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 det ailed information on alcoholism treatment rates, alcohol habits, viral hepatitic infections and other factors involved in the aetiopathogene sis of the disease.