Distribution and Incidence
Cirrhosis is distributed worldwide, affecting all races, nationalities, ages, and both sexes. Well over 300,000 persons die of the disease annually. This figure, based on World Health Organization statistics of the 1960s, is an underestimate because countries such as mainland China and the former Soviet Union are not included.
In the United States in 1983, cirrhosis ranked as the ninth leading cause of mortality, accounting for 27,000 deaths.The worldwide incidence of cirrhosis is determined chiefly by the per capita consumption of alcohol and the prevalence of the hepatitis viruses. The rise in the number of cases of cirrhosis is attributable to an increase in one or both of these factors. Based on mortality statistics (WHO data, 1983 or 1984), the incidence of cirrhosis in various countries can be grouped as follows:
1. Low incidence (less than 10 cirrhotic deaths per 100,000 population): Canada, Venezuela, England, Scotland, Sweden, Netherlands, Australia, Hong Kong, and the United Arab Republic.
2. Intermediate incidence (11-23 per 100,000): Mexico, United States, Denmark, and Japan.
3. High incidence (greater than 24 per 100,000): Chile, Austria, Italy, France, West Germany, and Portugal.
Occurrence rates for the different types of cirrhosis are presented in Table VIII.28.1.