title: Evolution of the determinants of chronic liver disease in Quebec.
abstract: BACKGROUND
  Chronic liver diseases (CLDs) are a worldwide problem. Morbidity and mortality due to CLDs could be avoided or reduced by targeting the main risk factors, including obesity and alcohol use.
  
  
  METHODS
  To describe the evolution of the key determinants of CLDs in Quebec, we studied the trends in obesity, alcohol use, viral hepatitis B and C, CLD mortality and hospitalization rates, and the liver cancer incidence rate between January 1, 1981, and December 31, 2009.
  
  
  RESULTS
  We observed an increase in the obesity indicators among young men and in alcohol use among adolescent girls and middle-aged women. The overall hepatitis B and C incidence and CLD mortality rates are falling. However, liver cancer and mortality rates, especially among men and the elderly, are on the rise.
  
  
  CONCLUSIONS
  These results highlight the importance of targeted public health interventions and of maintaining or improving access to care for CLDs.
authors.affiliation: Direction des risques biologiques et de la santé au travail, Institut national de santé publique du Québec, Montréal, Quebec, Canada.
authors.forename: A J
authors.initials: AJ
authors.lastname: Sanabria
authors.forename: R
authors.initials: R
authors.lastname: Dion
authors.forename: E
authors.initials: E
authors.lastname: Lúcar
authors.forename: J C
authors.initials: JC
authors.lastname: Soto
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects / Q000453:epidemiology; D002908:Chronic Disease; D005260:Female; D006525:Hepatitis, Viral, Human / Q000453:epidemiology; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008107:Liver Diseases / Q000453:epidemiology* / Q000209:etiology* / Q000401:mortality; D008113:Liver Neoplasms / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000453:epidemiology; D011792:Quebec / Q000453:epidemiology; D012307:Risk Factors
keywords: chronic disease; chronic liver disease; epidemiology; liver disease; risk factors