title: The rising tide of liver Cirrhosis mortality in the UK: can its halt be predicted?
abstract: OBJECTIVE
  To explore whether it is possible to predict future United Kingdom (UK) death rate of liver cirrhosis based on birth cohort models.
  
  
  METHODS
  Routinely available mortality data were plotted graphically to display the trends in cirrhosis mortality by birth cohort in several countries. Data for Italy, France, Portugal, USA, Canada, Scotland and England & Wales were plotted by birth cohort.
  
  
  RESULTS
  The current increase in cirrhosis mortality in the UK countries is being driven by a birth cohort effect. Later birth cohorts have much higher death rates than preceding ones. This pattern was seen in Western European and North American countries, which had also experienced increases in liver cirrhosis mortality. However, after the increases, those countries had sudden and persistent falls in death rates. For each country, the dramatic reversal of death rates occurred at a single calendar period and in every age group simultaneously.
  
  
  CONCLUSIONS
  Prediction of future death rates using information from previous cohorts is not possible due to the occurrence of sudden reversals in death rates. The sudden fall in the death rates of several birth cohorts suggests that reversing the current UK trend of rising liver cirrhosis deaths is possible.
authors.affiliation: Division of Clinical and Population Sciences and Education, University of Dundee, Mackenzie Building, Kirsty Semple Way, Dundee DD2 4BF, UK. k.dunbar@cpse.dundee.ac.uk
authors.forename: John K
authors.initials: JK
authors.lastname: Dunbar
authors.forename: Iain K
authors.initials: IK
authors.lastname: Crombie
mesh_terms: D000367:Age Factors; D019973:Alcohol-Related Disorders / Q000401:mortality*; D015331:Cohort Studies; D016208:Databases, Factual; D005060:Europe; D005260:Female; D005544:Forecasting; D006801:Humans; D008103:Liver Cirrhosis / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000208:ethnology / Q000639:trends; D009656:North America; D036801:Parturition; D012307:Risk Factors; D006113:United Kingdom / Q000453:epidemiology