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Delayed Increases in Liver Cirrhosis Mortality and Frequency of Alcoholic Liver Cirrhosis Following an Increment and Redistribution of Alcohol Consumption in Finland: Evidence from Mortality Statistics and Autopsy Survey Covering 8533 Cases in 1968–1988
Author(s) -
Savolainen V. T.,
Penttilä A.,
Karhunen P. J.
Publication year - 1992
Publication title -
alcoholism: clinical and experimental research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.267
H-Index - 153
eISSN - 1530-0277
pISSN - 0145-6008
DOI - 10.1111/j.1530-0277.1992.tb00655.x
Subject(s) - cirrhosis , autopsy , medicine , alcohol consumption , alcoholic liver disease , redistribution (election) , demography , alcohol , alcoholic hepatitis , consumption (sociology) , biology , biochemistry , sociology , social science , politics , political science , law
Changes in the legal restrictions for alcohol consumption in 1969 liberated purchasing and marketing of low‐alcohol beer. Subsequently, within the space of 5 years, the per capita consumption of absolute alcohol increased from 4.2 to 6.5 liters. To evaluate the possible effects of this change upon liver cirrhosis mortality as well as prevalence of liver cirrhosis in autopsy series, we surveyed mortality statistics and data from 8,533 medicolegal autopsies in 1968 through 1988. Liver cirrhosis mortality statistics revealed a highly significant ( p < 0.001) increase from 6.4 to 13.7 per 100,000 during the period, and similarly, the prevalence of liver cirrhosis in the autopsy series showed a highly significant ( p < 0.001) increase from 3.0% to 6.1%. More specifically, this increase was attributable to a highly significantly (Chi‐square 15.4, p < 0.001) increased proportion of alcoholic liver cirrhosis occurring at a younger age and almost exclusively in males. The stepwise mode of increase as well as the changes in sex and age distribution of cirrhosis since 1969 could be interpreted as an effect of distribution of consumption to a new generation of consumers. The forensic autopsy series seemed to reflect changes in per capita consumption with a shorter time lag than with mortality statistics. Additionally, only 7% of the 448 cirrhosis singled out from this material exhibited liver cirrhosis as a cause of death and were thus also included in the official mortality statistics, suggesting the greater accuracy of our forensic autopsy series.