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. 2014 Oct 1;120(19):3058-65.
doi: 10.1002/cncr.28843. Epub 2014 Jun 10.

Temporal trends in population-based death rates associated with chronic liver disease and liver cancer in the United States over the last 30 years

Yuhree Kim  1 , Aslam Ejaz, Amit Tayal, Gaya Spolverato, John F P Bridges, Robert A Anders, Timothy M Pawlik
Affiliations

Temporal trends in population-based death rates associated with chronic liver disease and liver cancer in the United States over the last 30 years

Yuhree Kim et al. Cancer. .

Abstract

Background: The health and economic burden from liver disease in the United States is substantial and rising. The objective of this study was to characterize temporal trends in mortality from chronic liver disease and liver cancer and the incidence of associated risk factors using population-based data over the past 30 years.

Methods: Population-based mortality data were obtained from the National Vital Statistics System, and population estimates were derived from the national census for US adults (aged >45 years). Crude death rates (CDRs), age-adjusted death rates (ADRs), and average annual percentage change (AAPC) statistics were calculated.

Results: In total, 690,414 deaths (1.1%) were attributable to chronic liver disease, whereas 331,393 deaths (0.5%) were attributable to liver cancer between 1981 and 2010. The incidence of liver cancer was estimated at 7.1 cases per 100,000 population. Mortality rates from chronic liver disease and liver cancer increased substantially over the past 3 decades, with ADRs of 23.7 and 16.6 per 100,000 population in 2010, respectively. The AAPC from 2006 to 2010 demonstrated an increased ADR for chronic liver disease (AAPC, 1.5%; 95% confidence interval, 0.3%-2.8%) and liver cancer (AAPC, 2.6%; 95% confidence interval, 2.4%-2.7%).

Conclusions: A comprehensive approach that involves primary and secondary prevention, increased access to treatment, and more funding for liver-related research is needed to address the high death rates associated with chronic liver disease and liver cancer in the United States.

Keywords: chronic liver disease; epidemiology; liver cancer; mortality.

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Conflict of interest statement

CONFLICT OF INTEREST DISCLOSURES

Dr. Ejaz is supported by the E. B. Pillsbury Foundation. Dr. Anders reports grants from the National Institutes of Health and grants and other support from Bristol-Myers Squibb during the conduct of the study.

Figures

Figure 1
Figure 1
Trends in the incidence and prevalence of various risk factors for liver cancer are illustrated. BMI indicates body mass index (measured in kg/m2).
Figure 2
Figure 2
Trends in age-adjusted death rates are illustrated using Joinpoint analyses from (A) all causes, (B) all cancer. APC indicates annual percentage change. P ≤ .05.
Figure 3
Figure 3
Trends in age-adjusted death rates are illustrated using Joinpoint analyses from (A) liver cancer (B) chronic liver disease and cirrhosis, (C) alcoholic liver disease, and (D) viral hepatitis. APC indicates annual percentage change. P ≤ .05.
See this image and copyright information in PMC

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