Rapid increase in deaths due to alcohol-related liver disease

Research led by the University of Michigan in Ann Arbor has made a disturbing find about deaths related to cirrhosis, a severe liver condition.

Cirrhosis can be caused by several different health issues, including hepatitis C and fatty liver disease.

But the researchers observed that in the United States, an increasing number of people acquire it due to excessive alcohol consumption.

Dr. Elliot Tapper — who is a specialist in liver health from Michigan Medicine, of the University of Michigan — and his collaborator Dr. Neehar Parikh have noticed that, in 1999–2016, the number of deaths caused by cirrhosis has been on the rise in 49 out of 50 states.

“Each alcohol-related death,” explains Dr. Tapper, “means decades of lost life, broken families, and lost economic productivity. In addition, medical care of those dying from cirrhosis costs billions of dollars.”

The researchers’ findings are reported in the BMJ.

Young adults most at risk

The past few years have witnessed much better results when it comes to treating hepatitis C, the liver disease that has affected large numbers of “Baby Boomers” — people born in 1945–1965 — who were exposed to infection via improperly sanitized needles, due to a poor understanding of the dangers involved.

Once methods of dealing with the widespread cases of hepatitis C improved, and people who had been diagnosed experienced better care, liver specialists hoped that they would see fewer deaths related to liver disease.

Surprisingly, however, they found the opposite: cirrhosis deaths have increased by 65 percent, and alcohol use is a prominent cause of late-stage liver disease. The most affected populations are adults aged 25–34, and white people and those who are of American Indian and Hispanic descent are the most exposed.

The highest average increase in cirrhosis-related deaths per year was seen among young adults, at an approximately 10.5 percent rise each year.

“We thought,” explains Dr. Tapper, “we would see improvements [when it comes to the number of deaths due to liver disease], but these data make it clear: even after hepatitis C, we will still have our work cut out for us.”

More deaths from liver cancer

But why exactly has alcohol use become such a prominent “pastime” among younger generations? The study authors believe that it may have something to do with the negative effects of the Great Recession, which took place roughly in 2007–2009.

The researchers were led to infer this due to the fact that the rise in cirrhosis-related deaths picked up in 2009.

“We suspect,” explains Dr. Tapper, “that there is a connection between increased alcohol use and unemployment associated with the global financial crisis. But more research is needed.”

During the 7-year period analyzed in this study, 460,760 cirrhosis-related deaths occurred. Of these, approximately one third were due to a type of liver cancer — called “hepatocellular carcinoma” — that stems from cirrhosis.

In 2016, the number of deaths caused by liver cancer doubled — reaching 11,073 — compared with 1999’s figures.

“The rapid rise in liver deaths underscores gaps in care and opportunities for prevention,” warns Dr. Parikh.

According to the data — collected using the Centers for Disease Control and Prevention’s (CDC) Wide-ranging Online Data for Epidemiologic Research — the states where most cirrhosis deaths have been recorded are Kentucky, Alabama, Arkansas, and New Mexico.

Only one state showed a decrease in liver disease-related mortality: Maryland.

The authors emphasize that liver disease due to alcohol consumption is entirely preventable and urge states to implement strategic measures, such as the implementation of alcohol taxes, and limiting adverts promoting alcoholic beverages.

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