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Cirrhosis incidence low in Sweden

Over the course of 10 years, cirrhosis incidence was lowest in Southern Sweden compared with all other European countries, according to results of a population-based study.

“In Sweden, the dominating causes of cirrhosis are alcohol overconsumption and hepatitis C. Previous studies on incidence, prevalence and prognosis in the Nordic countries are few. … The clinical course of cirrhosis in Sweden is unknown and a well-defined populations-based cohort is needed,” Emma Nilsson, MD, PhD, of Lund University, Malmö, Sweden, and colleagues wrote.

The researchers reviewed data from the Patient Administrative System in Skane — a population-based medical registry of all hospitals in the Southern region of Sweden — of all patients with liver cirrhosis within a population of 1.7 million between 2001 and 2011. Patients were all followed through December 2014 or until mortality.

The final analysis included 1,317 patients. The crude annual incidence of cirrhosis was estimated at 14.1 per 100,000 person-years (19.1 for men and 9.4 for women). The corresponding age-standardized incidence for cirrhosis was 17.8 per 100,000 person-years for men and 8.8 per 100,000 person-years for women.

When stratifying for age, cirrhosis incidence was higher in men aged 60 to 69 years and women aged 65 to 75 years. Overall incidence for cirrhosis was higher in men compared with women.

“No significant changes in incidence were observed during the study period,” the researchers wrote.

The most common etiology for cirrhosis was alcohol overconsumption with or without additional causes of cirrhosis (58%) followed by HCV alone (13%) and cryptogenic cirrhosis (12%).

The overall survival rates were 79% at 1 year, 47% at 5 years and 27% at 10 years. Women had a higher survival rate compared with men. In December 2010, 667 patients diagnosed with cirrhosis since 2001 were still alive. In the Scania region population, 994,464 people aged 18 years and older yielded a crude prevalence of 67 per 100,000 people within the 10 years.

“For comparison, prevalence in the U.K. was 76/100,000 persons,” the researchers wrote.

The researchers concluded: “Sweden continues to have a low incidence of cirrhosis compared with other European countries. Mortality varies with gender, etiology and severity at diagnosis. Patients with alcoholic cirrhosis with concomitant HCV infection fare worst.” - by Melinda Stevens

Disclosure: The researchers report no relevant financial disclosures.