- Overall mortality from selected alcohol-specific digestive causes declined in Spain 1999-2024, largely driven by reductions in alcohol-associated cirrhosis deaths.
- Alcoholic hepatitis and alcohol-induced chronic pancreatitis mortality increased among men, signalling persistent adverse trends for specific alcohol-related digestive diseases.
- Deaths were predominantly male (84%); mortality declined significantly in men but remained stable in women, with a joinpoint decline after 2010 and no COVID-19 inflection.
Rev Esp Enferm Dig. 2026 Sep 9. doi: 10.17235/reed.2026.12102/2026. Online ahead of print.
ABSTRACT
INTRODUCTION: Alcohol consumption is a major cause of preventable morbidity and mortality, contributing substantially to digestive diseases. However, long-term nationwide analyses of selected alcohol-specific digestive causes of death in Spain remain scarce.
OBJECTIVES: To characterize temporal trends and sex-specific patterns in mortality from selected alcohol-specific digestive diagnoses in Spain, 1999-2024.
MATERIAL AND METHODS: We conducted a nationwide, population-based ecological mortality trend study using national vital statistics data. Deaths were identified by underlying cause of death using ICD-10 codes for alcoholic gastritis, alcohol-associated liver disease, and alcohol-induced acute and chronic pancreatitis. Age-standardized mortality rates were calculated, and temporal trends were analysed using joinpoint regression to determine annual percentage changes and identify significant inflection points.
RESULTS: A total of 32,876 deaths were recorded, 84.0% among men. Overall mortality from alcohol-specific digestive causes declined significantly among men but remained stable among women. Joinpoint analysis identified a significant decline in overall mortality after 2010 in both sexes, with no additional inflection point during the COVID-19 pandemic. Alcoholic cirrhosis was the leading cause of death, accounting for 64.8% of all deaths, and its mortality rates declined over the study period. In contrast, mortality from alcoholic hepatitis and alcohol-induced chronic pancreatitis increased among men, whereas trends for the remaining alcohol-specific digestive diseases remained stable or declined.
CONCLUSIONS: Overall mortality from selected alcohol-specific digestive causes has declined in Spain over the past 26 years, largely driven by reductions in alcohol-associated cirrhosis mortality. Nevertheless, increasing mortality from alcoholic hepatitis and alcohol-induced chronic pancreatitis among men indicates persistent adverse trends for specific alcohol-specific digestive diseases. As this ecological study is based on underlying-cause-of-death coding and restricted to selected alcohol-specific ICD-10 diagnoses, it does not estimate the overall burden of alcohol-attributable digestive mortality.
PMID:42714116 | DOI:10.17235/reed.2026.12102/2026
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