5.12.1. Introduction

In the late 1970s, the highest cirrhosis mortality rates (around 30-40/100,000 men and 10-16/100,000 women) in Europe were observed in Austria, France, Italy and Portugal, whereas the lowest ones (below 10/100,000 men and 5/100,000 women) were registered in the UK and Nordic countries (La Vecchia et al, 1994). Subsequently, mortality from cirrhosis tended to decline in Southern European countries, but to rise in Northern, and mostly in Central and Eastern Europe reaching rates over 58/100,000 men and 22/100,000 women in Hungary in 1990 (Corrao et al, 1997; La Vecchia et al, 1994). A substantial increase in cirrhosis mortality over the last two decades has also been reported in the UK, mainly in Scotland (Leon and McCambridge, 2006).

In order to monitor recent trends in Europe, we have systematically reviewed mortality from cirrhosis up to 2002,and quantified the changes in trends since 1970 (Kim et al, 2000; Bosetti et al, 2007). The patterns in mortality from cirrhosis are largely due to changes in the major recognized causes of this disease, i.e., hepatitis B and C virus (HBV and HCV) infection and alcohol drinking: the control of alcohol drinking is the most immediate instrument to obtain a favourable impact on cirrhosis.

In relation to the important role of HBV and HCV in causing liver cirrhosis, this Chapter can be read in connection with the relevant Sections of Chapter 6.