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Age-period-cohort effects in alcoholic liver disease mortality in France from 1968 to 2010

Abstract : BackgroundPer capita alcohol consumption in France has historically been among the highest levels in Europe. In more recent history, however, consumption (mostly wine) has substantially decreased as has alcohol-related mortality. The present study characterizes age, period, and cohort (APC) trends in liver disease in France for the past four decades.MethodsData were drawn from overall French death certificates records covering the years 1968 to 2010. Liver disease mortality was defined from underlying cause ICD 8, 9, and 10 codes. We estimated age, period, and cohort effects, by sex, using Poisson modeling estimation and Clayton & Shiffler’s approach to model identification for APC modeling.ResultsLiver disease mortality exhibited significant age, period and cohort effects. The overall mortality rates were 25/100,000 for men and 9/100,000 for women over the period of data collection, with mortality increasing across age and peaking around age 70. Among males, there was no cohort effect and a clear and significant period effect; the risk of liver cirrhosis mortality in men has been steadily decreasing for all age groups across time. Conversely among women, there was a similar decreasing period effect but a strong and significant cohort effect as well. Specifically, there was a positive cohort effect for cirrhosis mortality for women born before around 1960 with the risk of liver cirrhosis for those cohorts between 4.0 and 5.0 times higher than the risks for those born after 1970, controlling for age and period effect.ConclusionLiver disease mortality has been decreasing in France for the past four decades, across all age groups and across men and women. Women born in older cohorts have much higher risks of dying from liver disease compared with women in younger cohorts, controlled for age, which may be a function of different beverage consumption patterns.
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Submitted on : Friday, April 17, 2020 - 5:49:22 PM
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Km Keyes, N. Le Meur, A. Hamilton, G. Rey, Olivier Grimaud. Age-period-cohort effects in alcoholic liver disease mortality in France from 1968 to 2010. European Journal of Public Health, Oxford University Press (OUP): Policy B - Oxford Open Option D, 2015, 25 (suppl_3), ⟨10.1093/eurpub/ckv175.226⟩. ⟨hal-02546254⟩



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