The deaths linked to the end stages of liver damage jumped by 65% with alcohol a major cause, adults age 25-34 the biggest victims and fatalities highest among whites, American Indians, and Hispanics.

 

Liver specialist Elliot B. Tapper, M.D., says he has witnessed the disturbing shift in demographics among the patients with liver failure treats at Michigan Medicine. National data collected by Tapper and study co-author Neehar Parikh, M.D., M.S., confirms that in communities across the country more young people are drinking themselves to death.

The data published in the journal BMJ shows adults age 25-34 experienced the highest average annual increase in cirrhosis deaths—about 10.5% each year. The rise was driven entirely by alcohol-related liver disease, the authors say.

"Each alcohol-related death means decades of lost life, broken families, and lost economic productivity," said Tapper, a member of the University of Michigan Division of Gastroenterology and Hepatology and health services researcher at the U-M Institute for Healthcare Policy and Innovation.

The rise in liver deaths is not where liver specialists expected to be after gains in fighting hepatitis C, a major liver threat often seen in Baby Boomers. Antiviral medications have set the course to one day eradicate hepatitis C.

Fatty liver disease

Cirrhosis can be caused by a virus like hepatitis C, fatty liver disease or alcohol abuse. The increase in liver deaths highlights new challenges in preventing cirrhosis deaths beyond hepatitis.

"We thought we would see improvements, but these data make it clear: even after hepatitis C, we will still have our work cut out for us," said Tapper.

That mortality due to cirrhosis began increasing in 2009—around the time of the Great Recession when the economic downturn led to a loss of people's savings, homes, and jobs—may offer a clue as to its cause.

"We suspect that there is a connection between increased alcohol use and unemployment associated with the global financial crisis. But more research is needed," Tapper said.

Cirrhosis caused a total of 460,760 deaths during the seven-year study period; about one-third were attributed to hepatocellular carcinoma, a common type of liver cancer that is often caused by cirrhosis, researchers found.

"The rapid rise in liver deaths underscores gaps in care and opportunities for prevention," said Parikh, study co-author and liver specialist at Michigan Medicine. The study's goal was to determine trends in liver disease deaths and which groups have been impacted most across the country. The research showed:

1. Fewer Asians and Pacific Islanders died of liver cancer.

2. It is hitting many places especially hard, namely Kentucky, Alabama, Arkansas and New Mexico, where cirrhosis deaths were highest.

3. A state-by-state analysis showed cirrhosis mortality is improving only in Maryland.

Deaths due to alcohol-related liver disease are entirely preventable, say authors who suggest strategies such as taxes on alcohol, minimum prices for alcohol and reducing marketing and advertising to curb problem drinking. Higher alcohol costs have been linked with decreased alcohol-related deaths.