Liver Disease Deaths Jump 25%, Alcohol Major Cause

'Stark Reading': Liver Disease Deaths Up 25%

Deaths from liver disease in England have jumped 25% with alcohol the major cause, men the biggest victims and fatalities more prevalent in the North, new statistics have revealed.

The figures, which one expert described as "stark reading", are certain to fuel further debate on how to tackle the problem of binge drinking.

The first ever National End of Life Care Intelligence Network report said the vast majority of the fatalities were people under 70, with more victims now in their 40s.

But obesity, hepatitis C and hepatitis B have also helped lead to the increase in total liver disease deaths between 2001 and 2009.

The findings are in contrast to other major causes of death - such as heart disease - which have been declining in recent years.

In 2001, 9,231 people died of the condition, but by 2009 it was 11,575 people, with 60% being men and 40% women.

Although numbers of deaths due to cancer, vascular or respiratory disease are still much greater, liver disease disproportionately kills people at a much younger age.

A striking 90% of people who die from liver disease are under 70, the report revealed.

More than one in 10 deaths of people in their 40s are from liver disease.

When measured as "years of life lost", liver disease is much more prominent, the report authors claimed.

Most of these deaths were from alcohol-related liver disease, which accounted for well over a third (37%) of all liver disease deaths.

But the prevalence of deaths from alcohol-related liver disease varied greatly between males (41% of liver disease deaths) and females (30% of liver disease deaths).

Alcohol-related liver disease was also more common in the most deprived areas (44% of liver disease deaths) than the least deprived areas (28% of liver disease deaths).

The complex needs of many patients mean that more than two-thirds died in hospital, compared with 55% of all deaths in 2009 from any cause - so leading to a greater cost to the NHS when treating the condition.

The North West is the region with the highest death rate from liver disease, according to the report, called Deaths from liver disease: implications for end of life care in England.

Using the age standardised mortality rate (2001-09), the area had 24 deaths per 100,000 of which 11.4 were from alcohol-related liver disease. Next came the North East at 21.9 deaths per 100,000, of which 10.1 were from alcohol-related liver disease and London was third highest with 20.2 deaths per 100,000, of which 6.5 were from alcohol-related liver disease.

The figures took into account the diverse populations of each region, for example the South East having the largest population and London having a relatively younger population.

The lowest areas for liver deaths was the East of England at 12.9 per 100,000, of which 4.9 were from alcohol-related liver disease, the South West at 14.3 per 100,000, of which 6.4 were from alcohol-related liver disease and the South East at 14.8 per 100,000, of which 5.8 were from alcohol-related liver disease.

Professor Martin Lombard, National Clinical Director for Liver Disease, said: "This report makes for stark reading about the needs of people dying with liver disease.

"Over 70% end up dying in hospital and this report is timely in helping us understand the challenges in managing end of life care for this group of people.

"The key drivers for increasing numbers of deaths from liver disease are all preventable, such as alcohol, obesity, hepatitis C and hepatitis B.

"We must focus our efforts and tackle this problem sooner rather than later."

Professor Julia Verne, lead author of the report and clinical lead for the National End of Life Care Intelligence Network, said:

"This report provides the first summary of key facts on deaths from liver disease, on which future discussions can be built.

"It is crucial that commissioners and providers of health and social care services know the prevalence of liver disease in their local areas, so that more people can receive the care they need to allow them to die in the place of their choosing."

Claire Henry, director of the National End of Life Care Programme, said: "Clinicians caring for people with liver disease need to be having conversations with them about end of life care.

"This is exceptionally challenging for those with liver disease, who are often younger, come from ethnically diverse or deprived backgrounds and may feel stigma associated with the disease.

"It's additionally complicated for those dying of alcohol-related liver disease, who may also have mental health or drug dependence problems and little family or social support.

"These factors make good communication about end of life care so important."

British Liver Trust chief executive Andrew Langford said the report showed that liver patients are still being failed by the healthcare system.

He said higher alcohol prices, the taxing of high fat food and testing for viral hepatitis would prevent many deaths.

"Liver disease has remained the poor relation in comparison to other big killers such as cancer and heart disease, yet liver disease is the only big killer on the rise," he said.

"The increasing numbers of people with, and dying from, liver disease leaves the UK at breaking point and we cannot afford to overlook these patients any longer.

"The current nature of the disease means that people are diagnosed late in their condition.

"This exposes the inadequacies in our healthcare system in identifying patients early and also the lack of will to invest in prevention strategies that will have a serious impact such as alcohol pricing, taxing high fat foods and testing for viral hepatitis."