Dynamics and variability of regional mortality rates from liver and biliary tract diseases in the period from 2019 to 2021

Objective: to assess the variability and dynamics of mortality from liver and bile duct diseases in the regions of Russia for the period of 2019–2021. Materials and methods. Rosstat data on the number of deaths according to form C51 and on the average annual population by one-year age groups by gender and age were used. Standardized mortality rates (SMRs) were calculated for 12 causes of death related to liver and bile duct diseases and included in the Brief Nomenclature of Causes of Death of Rosstat (BNCD) for 82 regions of the Russian Federation. Results. The mean SMRs from all liver and bile duct diseases in 2020 (42.4 ± 11.9 per 100,000 population) and 2021 (42.8 ± 13.2) were higher than in 2019 (39.4 ± 11.4), with annual increases observed in 38 regions, decreases in 7, and mixed trends in 37. The contribution of liver diseases to all-cause mortality was 3.95 ± 0.91% in 2019, 3.65 ± 0.85% in 2020, and 3.26 ± 0.92% in 2021. The highest SMRs were registered for liver fibrosis and cirrhosis, while the lowest SMRs were for acute hepatitis. Considerable variability in SMRs was observed between regions in 2021: the maximum SMR for liver cancer was more than 14 times higher than the minimum, while for liver fibrosis and cirrhosis it was 25 times higher. Hypotheses explaining the reasons for these differences are discussed. Conclusions. Significant regional variability in SMRs does not allow for a stable trend towards reducing mortality from these causes to be identified.