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In recent years, there has been a steady rise in the rate of Americans who die by suicide and drugs each year. Although much of the attention surrounding these deaths has been focused on the opioid crisis, a new study published Wednesday in the BMJ points to a different aspect of this increase: More people, especially young adults, are dying of Alcohol-related diseases such as liver cancer and cirrhosis.
Researchers at the University of Michigan studied death certificate data collected by the Centers for Disease Control and Prevention. From 1999 to 2016, nearly half a million Americans died of cirrhosis, a chronic liver disease where the body becomes progressively and irreparably healed and may ultimately fail completely. More than 130,000 of those killed also had hepatocellular carcinoma, the most common form of liver cancer that is usually caused by cirrhosis.
But compared to 1999, researchers found that the annual death rate from cirrhosis jumped 63% in 2016, while liver cancer deaths doubled. The increase was even more pronounced compared to other causes of death. Cancer mortality rates in general had actually declined over the same period, as had deaths from cardiovascular diseases, infections and respiratory diseases.
For lead author Elliot Tapper, the results seem to confirm
"We had a sense of our clinical life of treating a liver disease that epidemiology, it is to say the type of people treated for liver disease, had changed, "Tapper told Gizmodo. "We were shocked to find that our experience, limited to the few hospitals where we practiced, could be seen across the United States, albeit with a few geographical variations."
Although Tapper has looked as far back as 1999, the annual rise in cirrhosis deaths has only truly begun in 2008. And if cirrhosis is a chronic disease that can take years , or decades, to become fatal, the largest relative increase in mortality has been remarkably observed among young people. The annual mortality rate jumped by an average of 10% each year between 2009 and 2016 for people aged 25 to 34. And among these deaths, the increase was entirely attributed to cases caused by alcohol consumption. [This] wasn »Tapper said:
Other groups particularly likely to die of cirrhosis include whites and Native Americans, as well as people living throughout the south and west of the United States. Only one state, Maryland, has seen its cirrhosis mortality improve over the 18-year period.
Due to the increase in the number of deaths, all around the Great Recession, Tapper says that it is more than possible that the economy died.
"If this trend starts in 2008, it is fairly easy to associate this with the most traumatic national event that has taken place in recent times." And there is data that links the new poverty or unemployment and the increased abuse of alcohol among young men, "he said, while stressing that further research is needed to confirm any link. Deaths related to older Americans, Tapper added, such as a continued increase in obesity and diabetes, that may contribute to non-alcoholic fatty liver disease.
Meanwhile, the increase in alcohol-related cirrhosis is likely obscuring real advances in the prevention of other causes of liver diseases such as hepatitis C. Since 2014 , a new class of drugs has allowed doctors to cure most chronic infections (provided that people can afford it.)
"We cured more cases of hepatitis C in 2015 than we did. Made all the previous years, and we are making huge progress to completely eliminate it from the map. But we do not see any improvement in mortality, "said Tapper.
Part of the reason for this intangibility might simply be that enough time has passed to see the vital effects of these new treatments, said Tapper., highlighting research showing that liver transplants due to chronic hepatitis C have begun to drop dramatically. "[But] There must be opposing forces that mask the progress we have achieved in the treatment of hepatitis C, and alcohol is probably one of them. "
Despite the ominous findings, Tapper says that it is still time from
"We need to understand the best way to treat and manage addiction, but at the same time, we believe that policies that limit the availability or ability to abuse alcohol deserve to be explored, "he said. For example, why are some States particularly affected compared to others? A natural experience would be to see if price differences or state-based alcohol taxes could play a role. This is probably a good first step. "
Because cirrhosis can take decades to progress," he says, "there should also be more effort to detect liver disease before it reaches the point of death." non-return
[The BMJ]
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