American’s Dying from Drinking and Obesity is Alarming
Since Y 2009, a growing number of Americans have died from liver disease and liver cancer.
The increase among those 25- to 34 anni is especially troubling because the deaths are due to cirrhosis, a disease caused by excessive drinking of alcohol, the authors of a new study said.
The researchers suspect the economic downturn in Y 2008 prompted people to comfort themselves with alcohol.
“These are deaths of despair,” said lead researcher Dr. Elliot Tapper, an assistant professor of gastroenterology at the University of Michigan.
It’s similar to overdose deaths from the opioid epidemic. In both cases, people are trying to relieve the emotional pain they feel, Dr. Tapper said.
He cautioned, however, that because this is an observational study, it cannot prove cause and effect.
Cirrhosis scars the liver and causes damage that can lead to deadly conditions such as liver cancer and liver failure.
The most common causes of cirrhosis are drinking too much over many years, hepatitis C or a build-up of excess fat in the liver, known as fatty liver disease, the study authors noted.
While young people are dying from alcohol-related cirrhosis, older people are dying from liver cancer and non-alcoholic fatty liver disease, Dr. Tapper explained.
The conditions affecting older people are most likely due to the obesity epidemic, he suggested. In many cases, liver disease can be prevented by living a healthy lifestyle.
If cirrhosis is caught early, the liver will repair itself, Dr. Tapper said, and losing weight can reverse fatty liver disease.
Dr. Raymond Chung is director of the Hepatology and Liver Center at Massachusetts General Hospital, in Boston.
He said the increased deaths may stem from several factors, including complications of the hepatitis C epidemic, as well as the high frequency of fatty liver disease in the US population.
The deaths of very young adults are striking, added Dr. Chung, who is also on the governing board of the American Association for the Study of Liver Diseases.
“We do not yet understand why this is happening in this age group, and further study is required to determine whether this is due to sheer quantity or type of alcohol consumed, genetic factors or the presence of other forms of liver injury,” Dr. Chung said.
For the study, Dr. Tapper’s team reviewed death certificate data for nearly 600,000 U.S. adults.
Between Ys 1999 and 2016, deaths from cirrhosis increased by 65% (from about 20,600 in 1999 to nearly 34,200 in Y 2016). Deaths from liver cancer doubled (from more than 5,100 to nearly 11,100) during the same time frame.
Compared to women, men had nearly twice as many deaths from cirrhosis and almost 4X as many from liver cancer, the study authors said.
From Ys 2009 to 2016, people aged 25 to 34 had the highest annual increase in cirrhosis deaths, nearly 11%. Deaths from liver cancer among those under 55 anni, meanwhile, decreased, but rose among people over 55, Dr. Tapper said.
The greatest increase in deaths from cirrhosis was seen among whites, Native Americans and Hispanics, the researchers said.
Deaths from cirrhosis and liver cancer rose fastest in western and southern states. For example, deaths in Kentucky rose nearly 7%, in New Mexico 6% and in Arkansas nearly 6%.
Only 1 state, Maryland, saw a significant decrease in cirrhosis deaths, of about 1%, the findings showed.
According to Dr. David Bernstein, Chief of hepatology at Northwell Health in Manhasset, NY, “This study highlights the silent epidemic of advanced liver disease in the United States, which largely remains unrecognized and unacknowledged by the collective medical leadership.”
Dr. Bernstein added that “the paper should be a wake-up call to the medical community, and especially to healthcare policymakers and administrators that we need to focus on disease prevention and risk-factor modification, while at the same time shifting resources to address the already growing burden of cirrhosis and liver cancer.”
The report was published online 18 July in the BMJ.
A report from the US Centers for Disease Control and Prevention (CDC) released earlier this week echoed these findings.
Between Ys 2000 and 2016, liver cancer deaths were up 43% for men and 40% for women aged 25 and older, the CDC reported.
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