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Epidemiology of liver disease

Liver disease – a growing problem

Liver disease is becoming ever more important and deaths from liver disease are rising across the world. While deaths in the UK from cardiovascular disease, lung disease, cancer, diabetes and are all falling, liver disease deaths have increased by 12% from 2005 to 2008.

The three major aetiologies contributing to this burgeoning epidemic of liver failure are non-alcoholic fatty liver disease (NAFLD), viral hepatitis and alcoholic liver disease. A lesser but still important contribution comes from autoimmune liver diseases, which are also increasing in prevalence. An accurate estimate of the full extent of liver disease is not available, primarily because of a lack of good diagnostic tests.

Estimates for NAFLD alone range from 10-50% of all Western populations and approximately 450 million people worldwide may be affected.

Liver disease is UK's number one health priority

‘Liver disease has emerged as a key theme from international comparisons which show that this is the only major cause of mortality and morbidity which is on the increase in England whilst decreasing among our European neighbours. Among the causes of the increasing numbers of people with liver disease are obesity, undiagnosed hepatitis infection, and increasingly, harmful alcohol use. These causes are all preventable but the individual’s role in responding to the threat of liver disease is often undermined by the fact that it progresses unnoticed for many years. Liver disease does not manifest with obvious symptoms or signs until a relatively late stage. Preventative measures should involve a combination of public health policy initiatives (action on obesity and harmful alcohol use) and better awareness amongst the public of their liver health. Equally important, service providers should continue to improve their efforts to detect early signs of liver disease. This will entail appropriate risk assessment strategies in their populations, and use of appropriate tests to identify liver disease that can be reversed or treated.’

Dame Sally Davies, the Chief Medical Officer, from her annual report On the State of the Public’s Health (Professor Dame Sally Davies, Department of Health, November 2012)