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Transforming the landscape of liver disease in the UK – new Lancet report

Gathering momentum for the way ahead: the fifth report of the Lancet Standing Commission on Liver Disease in the UK, published today, showcases the progress made and provides a substantial addition to European and global health data on the extent of the liver disease burden.

Examples of the progress being made include

  • The British Liver Trust and Royal College of General Practitioners renewed commitment to driving forward screening programmes so that high-risk patients are identified much earlier in primary care.
  • Innovative programmes, such as the Nottingham Scarred Liver Project, are providing resources for general practitioners to identify patients with hazardous alcohol use for counselling interventions and transient elastography liver function tests.
  • The widespread availability of new curative antiviral treatments for hepatitis C virus in the UK has transformed care, bringing the WHO target for eliminating hepatitis C virus by 20303 within reach.
  • The UK waiting list for liver transplants in 2017–18 reduced to almost half of that in 2014–15.
  • In Scotland, a minimum unit price for alcohol was introduced in May, 2018,

The report also emphasises the efforts of the alcohol industry to undermine work to reduce unsafe levels of drinking. Figures reveal that most people in the UK are unaware that most people in the UK are unaware that alcohol consumption at a level considered social drinking can be harmful, and that alcohol dependency simply lies at the extreme end of the harm spectrum.

Worrying findings from a study of drinking patterns and liver cirrhosis from the UK Million Women Study reveals an increase in cirrhosis incidence in middle-aged women, even at moderate levels of consumption.

Other concerns that are highlighted include

  • The increasing incidence of hepatocellular carcinoma (HCC) and the need for much earlier diagnosis.
  • The gap in services to support people with obesity and the fact that the incidence of those with non-alcohol related steatohepatitis continues to rise

The report identifies the following key priorities

  • Financial regulatory measures such as minimum unit pricing and the alcohol duty escalator
  • Extending the RCP accreditation scheme and the British Liver Trust’s work with the RCGP to enable general practitioenrs to identify and better manage patients with liver disease
  • Encouraging wider roll out of integrated care pathways
  • Countering the lobbying activities of the food and alcohol industries

The Lancet Commission into Liver Disease in the UK is supported by key health care organisations and charities including the British Liver Trust.

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