Effect of age, birth cohort and period of death on Italian liver cirrhosis mortality, 1972-1986

G. Corrao, P. Torchio, A. De Carli, G. Galatola, S. Arico, F. Di Orio

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Liver cirrhosis is one of the main causes of death in Mediterranean countries. A trend towards a global reduction in the mortality rate has been recently reported. In order to clarify better this trend and in an attempt to hypothesize the future pattern of mortality, we analysed data from 254834 Italian subjects aged 30-79 who died from liver cirrhosis during the period 1972-1986. We used a log-linear Poisson model to examine the effects of age, calender period of death and birth cohort. Our data confirm that both in the population as a whole and after stratification for three geographical areas (Northern, Central and Southern Italy) the mortality rate is decreasing. The age-effect analysis showed an exponentially rising effect in the Southern population, in accordance with the viral aetiology of cirrhosis, whereas an increased effect followed by a decreased effect was observed in the Northern end Central population, suggesting the alcoholic aetiology for the disease. The results from the birth-cohort effect suggested that in the Northern and Central populations mortality should continue to decrease over the next decade, possibly due to the implementation of better prevention programmes for cirrhotics and to decreased alcohol consumption in Italy. In the Southern population, however, mortality is still rising and this will probably continue for the next decade, as the generations born between 1940 end 1950 who are at high risk of carrying chronic hepatitis B virus infection, reach the age of higher risk of death from liver cirrhosis. We conclude that such an epidemiological approach may help in understanding the variations of the trends of mortality from liver cirrhosis and make it possible to hypothesize the future trend pattern, thus helping to target more appropriately health care and prevention programmes.

Original languageEnglish
Pages (from-to)475-482
Number of pages8
JournalInternational Journal of Epidemiology
Issue number3
Publication statusPublished - 1993

ASJC Scopus subject areas

  • Statistics, Probability and Uncertainty
  • Applied Mathematics
  • Epidemiology
  • Obstetrics and Gynaecology
  • Physiology (medical)
  • Reproductive Medicine


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