Cirrhosis Cases Rising Among Women in North America
Cirrhosis disease burden in women has increased substantially since 2000, according to a study presented at The Liver Meeting, the 2020 annual meeting of the American Association for the Study of Liver Diseases. Study investigators used administrative healthcare data from Ontario to assess the contemporary epidemiology of cirrhosis and liver-related complications in women and projected cirrhosis disease burden to 2040. The analysis was based on data from 65,217 women who were followed for a median of 5 years. The median age at diagnosis was 57 years, with cirrhosis etiology most commonly resulting from nonalcoholic fatty liver disease (NAFLD; 63%), followed by alcohol-related liver disease (ALD; 16%), hepatitis C virus (HCV; 10%), autoimmune liver disease (AI; 6%), and hepatitis B virus (HBV; 5%). Incidence rates for cirrhosis increased by 33% (average annual percent change [AAPC], 2.5%). The changes in incidence rate were greatest for ALD among women born after 1980 (AAPC, 12.8%/year), followed by NAFLD among women born between 1945 and 1964 (AAPC, 8.4%/year). By 2040, the incidence rate for cirrhosis is expected to increase by 8% due to increases in ALD (+42%) and NAFLD (+34%); declines are expected in HCV (−91%), HBV (−225%), and AI/other (−179%). “Clearly, a heightened recognition of these key drivers of cirrhosis is essential for both primary care providers and specialists alike and should influence the development and evaluation of public health initiatives,” the presenting author said in a statement.