The Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Cancer Epidemiology and Prevention Division, Warsaw, Poland.
Eur Addict Res. 2010;16(4):193-201. doi: 10.1159/000317248. Epub 2010 Jul 2.
Over the last decades, Europe has experienced dramatic changes in the geographical variation of liver cirrhosis rates. We attempt to provide a comprehensive analysis of patterns and trends in liver cirrhosis mortality in European countries and regions.
Age-standardized (world standard) liver cirrhosis mortality rates per 100,000 person-years at ages 20-64 for 35 separate countries were computed using the World Health Organization Mortality Database.
In the analyzed period (1959-2002), a very strong East-to-West gradient in mortality rates was observed. An increase of the burden of mortality due to liver cirrhosis appeared in Eastern Europe in two specific areas: South-eastern Europe and North-eastern Europe. In the first group of countries, liver cirrhosis mortality was 10-20 times higher than in most other European states, levels never before observed in Europe. In the countries of North-eastern Europe (former Soviet Union countries) liver cirrhosis mortality was characterized by dramatic changes (both positive and negative) in specific periods of time.
Despite the fact that the etiology of liver cirrhosis is multifactorial, it seems that alcohol drinking is the factor that best explains the observed patterns in frequency of this disease in Europe. Alcohol control policies in Central and Eastern Europe could lead to an appreciable reduction of premature mortality from liver cirrhosis.
在过去几十年中,欧洲地区肝硬化发病率的地域分布发生了显著变化。本研究旨在对欧洲国家和地区的肝硬化死亡率的变化趋势和模式进行全面分析。
利用世界卫生组织死亡率数据库,计算了 35 个独立国家/地区 20-64 岁人群标准化(世界标准)每 10 万人年的肝硬化死亡率。
在分析期间(1959-2002 年),死亡率呈现出明显的从东向西递增的梯度分布。东欧地区有两个特定区域的肝硬化死亡率负担呈上升趋势:东南欧和东北欧。在前一组国家中,肝硬化死亡率比欧洲大多数其他国家高 10-20 倍,这是欧洲从未出现过的水平。在东北欧国家(前苏联国家),肝硬化死亡率在特定时期呈现出急剧变化(既有上升也有下降)。
尽管肝硬化的病因是多因素的,但饮酒似乎是解释欧洲该疾病发病率变化模式的最佳因素。中欧和东欧的酒精控制政策可能会显著降低肝硬化导致的过早死亡率。