The uses of multiple causes of death data to clarify changing patterns of cirrhosis mortality in Massachusetts.

Evaluation of death rates from cirrhosis of the liver in Massachusetts since 1950 indicate a changing pattern suggestive of a substantial increase in the frequency with which cirrhosis is being recorded as the underlying cause of death. By comparing the relationship between the frequency with which cirrhosis is mentioned on the death certificate with its occurrence as the underlying cause of death, it would appear that the increase in death rate represents a real change. Additional evidence is presented to indicated that the increase is occuring in the urban center of the state. Males aged 40-49 and females aged 50-59 have shown the greatest changes. In spite of similar changes occuring on the national scene, the increase appears to be substantially greater in Massachusetts. The evaluation of multiple cause of death as mentioned on death certificates can allow for assessment of significant co-factors contributing to a fatal outcome in a disease like cirrhosis of the liver.