LIVER-CIRRHOSIS MORTALITY TRENDS IN EASTERN-EUROPE, 1970-1989 - ANALYSES OF AGE, PERIOD AND COHORT EFFECTS AND OF LATENCY WITH ALCOHOL-CONSUMPTION

There is evidence that in some Eastern European countries alcohol-rela ted deaths have an important impact an mortality. In the whole Europea n population increasing trends in mortality were observed until the se cond half of the 1970s, followed by a decline in the following decades . By contrast, in Eastern Europe continuously rising trends have been observed. The aim of the present study is to describe cirrhosis mortal ity trends in Eastern European countries between 1970 and 1989. This i s a descriptive study in seven European countries, compared with Europ e as a whole. A Poisson's log-linear age-period-cohort model is used t o ascertain whether the recent trend in mortality represents a short-t erm fluctuation or an emerging long-term trend. In addition, changes i n cirrhosis death rates were regressed onto changes in per capita alco hol consumption (1961-89) in order to evaluate the latency period betw een trends. The birth-cohort effects suggested that in Eastern Europe as a whole, and in particular in Hungary, Bulgaria and Romania, the mo rtality will probably increase in the next decade. Eastern European co untries showed a latency period between trends in alcohol consumption and in mortality rates of many years, whereas in Europe as a whole the cirrhosis mortality rates were explained by their relationship with p er capita alcohol consumption which lagged by only a few years. Furthe r increases in cirrhosis mortality, and probably in other alcohol-rela ted problems, are expected in several Eastern European countries. Epid emiological studies aimed to estimate the proportion of disease attrib utable to known risk factors of cirrhosis, and monitoring programmes o f viral infections and of alcohol consumption and alcohol-related prob lems, should be implemented to address the planning of public health p rogrammes.