Epidemiology

Cirrhosis mortality rates skyrocketing in the UK

Last Updated: 2006-01-05 15:05:38 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Fueled by increasing alcohol consumption, rates of mortality due to liver cirrhosis are climbing steadily in England, Wales, and especially Scotland, while rates are trending downward in other western European countries, investigators report in the January 7th issue of The Lancet.

Recorded alcohol consumption doubled in Britain between 1960 and 2002, note co-authors Dr. David A. Leon, from the London School of Hygiene and Tropical Medicine, and Dr. Jim McCambridge, from King's College London. They attribute the increase to reductions in the price of alcohol, increased availability, and heavy promotion by the alcohol industry.

To see how this increase has shaped cirrhosis mortality, the researchers evaluated data from the World Health Organization's Mortality Database as of August 2005.

They found that England and Wales had the lowest rates of cirrhosis mortality among western European countries from 1957 to 1962. A steady increase in cirrhosis mortality accelerated in the 1980s and again from 1990 onwards until 2002. Since 1950-1954, rates increased five-fold among men in England and Wales, and six-fold in Scotland. In women, the rates increased by a factor of four.

The authors note that Scotland has some of the highest cirrhosis mortality rates in western Europe.

In other western European countries, by contrast, mortality rates peaked in the early 1970s, then fell by approximately 25% to 30%.

The British mortality rates may also be due to the epidemic of hepatitis C in injecting drug users, Dr. Leon and Dr. McCambridge note. However, this theory is contradicted by the finding that southern Europe has experienced a similar increase, but rates of cirrhosis there have been declining.

In a related commentary, Dr. Robin Room from Stockholm University blames the UK government's failure to address the problem of increasing alcohol consumption and the lack of data on alcohol use.

"In the well-developed international literature studying the impacts of alcohol policies," Dr. Room adds, "UK studies are conspicuously rare."

Lancet 2006;367:10-11,52-56.