Liver disease must be tackled through policy and awareness

Liver disease cases continue to rise in England, despite falling in other European countries, and must be tackled through government policy and public awareness, England's chief medical officer (CMO) says.

Professor Dame Sally Davies said liver disease has ‘emerged as a key theme from international comparisons’
Professor Dame Sally Davies said liver disease has ‘emerged as a key theme from international comparisons’

In her first annual report as CMO, Professor Dame Sally Davies said liver disease had ‘emerged as a key theme from international comparisons’.

‘This is the only major cause of mortality and morbidity which is on the increase in England whilst decreasing among our European neighbours,’ she said.

‘Between 2000 and 2009, deaths from chronic liver disease and cirrhosis in the under 65s increased by around 20% while they fell by the same amount in most EU countries.’

The major causes of liver disease are preventable, Dame Sally pointed out.

‘Among the causes of the increasing numbers of people with liver disease are obesity, undiagnosed hepatitis infection and, increasingly, harmful alcohol use,’ she said.

‘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.’

Dame Sally said that preventive measures against liver disease need to involve a combination of public health policy initiatives to combat obesity and harmful alcohol use, and better awareness amongst the public of liver health.

‘Equally important, service providers should continue to improve their efforts to detect early signs of liver disease,’ she said. ‘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.

'These measures need to be integrated across all aspects of service provision for optimum efficacy but in, particular, a proactive approach needs to be adopted so that we reduce presentations at a late stage of disease.’

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