A startling jump in the number of people dying of liver disease has been triggered by an increase in alcohol consumption, Public Health England (PHE) has warned.
The first regional study into the preventable disease revealed a 40% rise in deaths over the past 12 years, with men twice as likely to be diagnosed as women.
The changes in pub opening hours and higher levels of alcohol consumption are directly linked to the “rapid and shocking” increase in death rates, according to Prof Julia Verne, who led the research for PHE.
The study uncovered a stark north-south divide, with more than four times as many male adults dying from the disease in Blackpool (58.4 per 100,000) than central Bedfordshire (13 per 100,000).
The results reveal significant variations in mortality across the country from liver disease – the only major cause of death and sickness which is on the rise in England while falling in the rest of Europe. As well as the variation in mortality rate, there are large variations in hospital admissions from liver disease.
Health experts have described death from liver diseases in the UK as a growing epidemic. It is the fifth “big killer” in England and Wales, after heart disease, cancer, strokes and respiratory disease. Between 2001 and 2012, the number of people who died with an underlying cause of liver disease in England rose from 7,841 to 10,948 – a 40% increase.
While about 5% of liver disease is attributable to autoimmune disorders (diseases characterised by abnormal functioning of the immune system), most liver disease is due to three main risk factors: alcohol, obesity and viral hepatitis.
“Liver disease is a public health priority because young lives are being needlessly lost,” said Verne. “All the preventable causes are on the rise, but alcohol accounts for 37% of liver disease deaths. We must do more to raise awareness, nationally and locally, and this is why it is so important for the public and health professionals to understand their local picture.”
Between 2001-03 and 2010-12, the average number of people per year who died with an underlying cause of liver disease in Blackpool increased from 58 to 64. The rate of alcohol specific hospital admissions in 2012-13 in Blackpool is significantly higher than the average in England for both males and females.
Andrew Langford, the chief executive of the British Liver Trust, welcomed the level of detail provided by the profiles in the PHE report. “They provide invaluable evidence as to how local authorities, clinical commissioning groups, public health professionals and the NHS can improve upon and increase prevention, early diagnosis and more timely care and treatment,” he said.
“These profiles, which were urgently needed, will begin to address the devastating rise of poor liver health throughout the country and reduce unnecessary deaths of increasingly younger people from liver disease.”
Verne said: “Liver disease develops silently and obvious signs and symptoms may only appear when changes are irreversible, therefore the identification of people with risk factors for liver disease in primary care is a critical first step in the pathway. Most people who die of liver disease don’t realise they’ve got it until a very late stage. While their life can be prolonged, they can’t be saved.”
He added: “Many patients come from marginalised groups with unstable accommodation, many don’t speak English and many may have difficulty attending or sticking to treatment because of addiction to alcohol and or drugs.”
In March, MPs urged the government to address the “catastrophic consequences” of ignoring the burden of liver disease. The all-party parliamentary hepatology group said the government, the NHS and PHE must take action to curb the increase. Recommendations included a minimum 50p unit price for alcohol and the coordination of a national approach to preventing disease as well as ensuring better care and early diagnosis.
