Incidence and prevalence of cirrhosis in the United Kingdom, 1992–2001: A general population-based study☆
Section snippets
Background
Cirrhosis is a major cause of death, accounting for an estimated 800,000 deaths each year worldwide [1]. In 2005, 1% of all deaths of people aged 25 years or over in England and Wales were attributed to chronic liver disease and cirrhosis according to death certification information [2]. In contrast to much of Western Europe, America and Australasia, where mortality from cirrhosis has remained constant or in decline, mortality from cirrhosis in the UK has tripled over the last few decades [3],
Methods
The General Practice Research Database (GPRD) is a longitudinal database consisting of anonymous computerised primary care records for over 13 million patients in the UK, including over 40 million person years of data. Data contained within this database, including diagnoses, clinical test results, observations, prescriptions and major medical events, are recorded through direct entry during face-to-face general practice appointments and also following information received from secondary care,
Study population
A total of 3360 incident cases of cirrhosis aged 25 or over were identified between 1992 and 2001, 58% of whom were male. The median age at diagnosis was 56.3 years in men and 61.3 years in women (p < 0.001). Thirteen per cent of cases had their first recording of cirrhosis concurrent with the recording of time of death following correspondence from secondary care services. Nearly two fifths of patients (n = 1287, 38.3%) had a recording of problem drinking within their GP records (Table 1). For
Discussion
We found a 45% increase in the incidence of cirrhosis in the UK in the decade between 1992 and 2001 and a 68% rise in the prevalence. Cirrhosis occurred more commonly and at younger ages in men than women. Nonetheless, a significant increase in incidence was seen for all age groups and for both sexes across the period under study. Incidence of both alcoholic and non-alcohol-related cirrhosis increased in males and in females during the period. Applying our 2001 prevalence and incidence figures
Acknowledgement
J.W. had the original idea for the study. K.M.F. and M.S.D. were responsible for data management. G.P.A. performed the case validation. K.M.F. performed the data analysis and drafted the original paper. J.W., T.C., G.P.A., and M.S.D. revised the paper critically and all authors approved the final version. K.M.F. acts as guarantor for this paper.
Funding: J.W. is funded by a Department of Health Clinician Scientist Fellowship. Funding for K.M.F. is within grant awarded to J.W. The Department of
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The authors declare that they do not have anything to disclose regarding funding from industries or conflict of interest with respect to this manuscript.