title: Temporal trends in population-based death rates associated with chronic liver disease and liver cancer in the United States over the last 30 years.
abstract: BACKGROUND
  The health and economic burden from liver disease in the United States is substantial and rising. The objective of this study was to characterize temporal trends in mortality from chronic liver disease and liver cancer and the incidence of associated risk factors using population-based data over the past 30 years.
  
  
  METHODS
  Population-based mortality data were obtained from the National Vital Statistics System, and population estimates were derived from the national census for US adults (aged >45 years). Crude death rates (CDRs), age-adjusted death rates (ADRs), and average annual percentage change (AAPC) statistics were calculated.
  
  
  RESULTS
  In total, 690,414 deaths (1.1%) were attributable to chronic liver disease, whereas 331,393 deaths (0.5%) were attributable to liver cancer between 1981 and 2010. The incidence of liver cancer was estimated at 7.1 cases per 100,000 population. Mortality rates from chronic liver disease and liver cancer increased substantially over the past 3 decades, with ADRs of 23.7 and 16.6 per 100,000 population in 2010, respectively. The AAPC from 2006 to 2010 demonstrated an increased ADR for chronic liver disease (AAPC, 1.5%; 95% confidence interval, 0.3%-2.8%) and liver cancer (AAPC, 2.6%; 95% confidence interval, 2.4%-2.7%).
  
  
  CONCLUSIONS
  A comprehensive approach that involves primary and secondary prevention, increased access to treatment, and more funding for liver-related research is needed to address the high death rates associated with chronic liver disease and liver cancer in the United States.
authors.affiliation: Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Yuhree
authors.initials: Y
authors.lastname: Kim
authors.forename: Aslam
authors.initials: A
authors.lastname: Ejaz
authors.forename: Amit
authors.initials: A
authors.lastname: Tayal
authors.forename: Gaya
authors.initials: G
authors.lastname: Spolverato
authors.forename: John F P
authors.initials: JF
authors.lastname: Bridges
authors.forename: Robert A
authors.initials: RA
authors.lastname: Anders
authors.forename: Timothy M
authors.initials: TM
authors.lastname: Pawlik
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000401:mortality*; D008113:Liver Neoplasms / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
keywords: chronic liver disease; epidemiology; liver cancer; mortality