The cirrhosis epidemic in the UK: evaluating the causes in a European context

'Epidemic' is defined as the occurrence of many cases of a disease within an area, whereas 'pandemic' is used to emphasize its occurrence over a wide geographical area. This article reviews the epidemiology of cirrhosis in Europe and particularly within Britain, illustrating the different mortality trends in different countries. The rapid rise in mortality rate in Scotland is discussed and potential explanations explored. The major causes of cirrhosis that are increasing, namely alcohol abuse, hepatitis C and nonalcoholic fatty liver disease, are reviewed. Hepatitis B, of course, remains a major cause of cirrhosis worldwide but is not responsible for the recent increased deaths from cirrhosis discussed in this article. The burden of this disease, which largely consists of variceal hemorrhage, hepatocellular carcinoma and orthotopic liver transplantation, are also discussed.