Mortality trends of liver diseases from 1981 to 2016 and the projection to 2035 in Taiwan: An age-period-cohort analysis

Background Projections on liver diseases mortality can provide a basis for evaluating the World Health Organization's "25 by 25" goal and can help healthcare systems design appropriate control strategies. This study evaluated whether the 25 by 25 goal can be achieved in Taiwan and discussed possible future control strategies. Methods Age-period-cohort models are used to estimate the mortality trends of liver diseases from 1981 to 2016 and project these trends to 2035. Results For chronic liver disease and cirrhosis among men, the age-adjusted mortality rate decreased from 1981 to 1991, increased until 1999, and subsequently decreased again until 2016. For women, the age-adjusted mortality rate exhibited an increasing but up-and-down trend from 1981 to 1998 and a decreasing trend to 2016. For liver cancer among men, the age-adjusted mortality rate exhibited an increasing trend from 1981 to 2002 and a decreasing trend to 2016. For women, the age-adjusted mortality rate exhibited an increasing trend from 1981 to 2003 and a decreasing trend to 2016. The age-adjusted mortality rates of chronic liver disease, cirrhosis and liver cancer for both sexes are projected to decrease by more than 30% from 2016 to 2025 and by more than 55% from 2016 to 2035. Conclusion These results indicated that the 25 by 25 goal can be achieved for liver diseases mortality in Taiwan. In addition to viral hepatitis, the following risk factors may become the major causes of liver diseases in Taiwan in the future: alcohol and tobacco use, diabetes and obesity.