EFFECT OF AGE, BIRTH COHORT AND PERIOD OF DEATH ON ITALIAN LIVER-CIRRHOSIS MORTALITY, 1972-1986

Citation
G. Corrao et al., EFFECT OF AGE, BIRTH COHORT AND PERIOD OF DEATH ON ITALIAN LIVER-CIRRHOSIS MORTALITY, 1972-1986, International journal of epidemiology, 22(3), 1993, pp. 475-482
Citations number
41
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Public, Environmental & Occupation Heath
ISSN journal
0300-5771
Volume
22
Issue
3
Year of publication
1993
Pages
475 - 482
Database
ISI
SICI code
0300-5771(1993)22:3<475:EOABCA>2.0.ZU;2-D
Abstract
Liver cirrhosis is one of the main causes of death in Mediterranean co untries. A trend towards a global reduction in the mortality rate has been recently reported. In order to clarify better this trend and in a n attempt to hypothesize the future pattern of mortality, we analysed data from 254 834 Italian subjects aged 30-79 who died from liver cirr hosis during the period 1972-1986. We used a log-linear Poisson model to examine the effects of age, calendar period of death and birth coho rt. Our data confirm that both in the population as a whole and after stratification for three geographical areas (Northern, Central and Sou thern Italy) the mortality rate is decreasing. The age-effect analysis showed an exponentially rising effect in the Southern population, in accordance with the viral aetiology of cirrhosis, whereas an increased effect followed by a decreased effect was observed in the Northern an d Central population, suggesting the alcoholic aetiology for the disea se. The results from the birth-cohort effect suggested that in the Nor thern and Central populations mortality should continue to decrease ov er the next decade, possibly due to the implementation of better preve ntion programmes for cirrhotics and to decreased alcohol consumption i n Italy. In the Southern population, however, mortality is still risin g and this will probably continue for the next decade, as the generati ons born between 1940 and 1950 who are at high risk of carrying chroni c hepatitis B virus infection, reach the age of higher risk of death f rom liver cirrhosis. We conclude that such an epidemiological approach may help in understanding the variations of the trends of mortality f rom liver cirrhosis and make it possible to hypothesize the future tre nd pattern, thus helping to target more appropriately health care and prevention programmes.