Prevalence of alcoholic cirrhosis rising in North American men
VIENNA — Researchers reported an increasing prevalence of alcoholic cirrhosis in a large representative Canadian population, especially among middle-aged men, according to a presentation at the International Liver Congress 2019.
“Over the last two decades, efforts to increase awareness of heavy drinking and improve access to care for alcoholic cirrhosis patients have been implemented,” Hassan Azhari, MD, from the University of Calgary in Canada, said during his presentation at ILC 2019. “However, the impact of these efforts has not been fully evaluated. We undertook this study to describe the epidemiology of alcoholic cirrhosis in a large North American cohort.”
Between 2013 and 2017, the overall annual age and sex-adjusted alcoholic cirrhosis incidence in the analyzed population from Alberta, Canada, was 38.9 cases per 100,000 for women and 55.6 cases per 100,000 for men with a female-to-male incidence rate ratio (IRR) of 0.42 (95% CI, 0.37-0.48).
The highest incidence rate was among men aged 40 years to 59 years (97.4 per 100,00) with an IRR of 6.87 (95% CI, 6.78-6.96) compared with men aged 80 years or older.
While incidence rates remained stable during the study period, prevalence rates increased from 107.7 cases to 158.2 cases per 100,000 (P <. 01). Prevalence was highest at 309.5 cases per 100,000 among men aged 60 years to 79 years with an IRR of 5.4 (95% CI, 5.31-5.49) compared with men aged 80 years or older.
Azhari and colleagues also identified 5,811 incident alcoholic cirrhosis cases in which the median age was 56 years (range, 48-63 years) and 69.8% were men.
Survival rates for the whole cohort were 66.9% at 1 year, 60.7% at 3 years, and 55.1% at 5 years, with 73% of the incident cohort presenting with decompensated cirrhosis at the time of index diagnosis. The age and sex-standardized mortality rate was 13.1 per 100,000 (95% CI, 12.5-13.7).
“Although the incidence of alcoholic cirrhosis is stable, prevalence in our Canadian cohort is increasing at an alarming rate,” Azhari concluded. “Better surveillance and early detection of alcoholic liver disease is urgently needed, and the development of effective health care practices are warranted to facilitate preventative measures and avoid alcoholic liver disease and late diagnosis.” – by Talitha Bennett
Azhari H. Abstract PS-175. Presented at: International Liver Congress; April 10-14, 2019; Vienna, Austria.
Disclosures: Healio Gastroenterology and Liver Disease was unable to confirm relevant financial disclosures at the time of publication.