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© 1991 Oxford University Press

research-article

A Method for Estimating Alcohol-Related Liver Cirrhosis Mortality in Japan

KIYOKO M PARRISH*,1, SUSUMU HIGUCHI**, TARO MURAMATSU{dagger}, FREDERICK S STINSON* and THOMAS C HARFORD**

*Alcohol Epidemiologic Data System, CSR, Incorporated 1400 Eye Street, NW, Washington, DC 20005 USA.
**The National Institute on Alcohol Abuse and Alcoholism RM 14C-26, 5600 Fishers Lane, Rockville, MD 20857 USA.
{dagger}The National Institute on Alcoholism, Kurihama National Hospital Yokosuka, Japan.

1Reprint requests to: Kiyoko M Parrish, Ph.D., First Steps Study, University of Washington, JD-02, Seattle, WA 98195, USA.

In Japan, per capita alcohol consumption increased sharply during the post World War II period followed by an increase in cirrhosis mortality. The prevalence of alcoholic cirrhosis among hospitalized patients also increased, from 11% in 1969 to 18% in 1985. Despite an increase in the percentage of drinkers among young women, over 80% of women in Japan are still abstainers or light drinkers. Thus, female cirrhosis mortality rates can be used as a proxy measure of non-alcohol-related cirrhosis mortality rates to estimate alcohol-related cirrhosis deaths among Japanese men. Employing this method, we conclude that two-thirds of cirrhosis deaths among men between 24 and 85 years of age and half of all cirrhosis deaths were attributable to alcohol. Two factors are probably responsible for the differences in proportional morbidity and proportional mortality of alcohol-related cirrhosis: differences in survival rates between alcoholic and non-alcoholic cirrhosis patients and detection bias toward post-hepatic cirrhosis. The synergistic effect of alcohol on viral hepatitis may in part explain excess cirrhosis deaths among Japanese men.

Revised 1 April 1991


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