Reductions in liver cirrhosis mortality and morbidity in Canada: demographic differences and possible explanations

In Canada, deaths from liver cirrhosis have declined by about 25% since 1974. To gain further insight into the nature of this decline, mortality rates for the years 1974-1984 and morbidity (hospital separation) rates for the years 1974-1980 were examined by age and sex and by province and sex. As well, survey data on drinking practices in Ontario were analyzed. Both mortality and morbidity declined over the time period involved, although variations over provinces, age groups, and sex were observed. The pattern of variations (largest declines in provinces with highest per capita alcohol consumption and in young to middle-aged males) strongly suggests decreased incidence of alcoholic liver cirrhosis. Among the factors which may be contributing to these declines are: the stabilization and small decreases in per capita consumption of alcohol; consumption pattern changes consistent with observed mortality and morbidity changes; expanded health promotion activities; and increases in the numbers of alcoholics receiving treatment.