Liver disease on the rise in Europe – up to half of cases can be prevented

Liver diseases such as cirrhosis and liver cancer have become more widespread in Europe in recent years – in contrast to many other major conditions, including cardiovascular diseases and several types of cancer, where mortality has declined. Liver disease is now one of the only major non-communicable diseases still increasing in Europe.

A new international report in The Lancet shows that these diseases cost European economies around €55 billion each year and account for nearly 300,000 deaths.

Among the authors is Aleksander Krag, professor of liver diseases at the University of Southern Denmark and Odense University Hospital, who points out that a large share of the disease burden could be prevented if known risk factors were addressed more consistently.

SDU researcher: the knowledge exists – action is lacking

– Liver disease costs the EU €55 billion annually and claims 780 lives every day. What is missing is not evidence, but action. We have the knowledge and the tools to prevent the majority of cases – the challenge now is to implement these solutions consistently across Europe, says Aleksander Krag, professor at the Department of Clinical Research (FLASH), University of Southern Denmark, and Odense University Hospital.

The report is published in The Lancet and draws on data from sources including the Global Burden of Disease study, as well as analyses of health and economics in Europe.

Alcohol and obesity driving the trend

The principal drivers are alcohol consumption, obesity and viral hepatitis. A growing share is driven by metabolic dysfunction-associated steatotic liver disease (MASLD) – a condition in which fat accumulates in the liver, often as a result of obesity and type 2 diabetes.

– If we reduce shared risk factors such as alcohol consumption and obesity, we could nearly halve the disease burden and add more than 10 months to average life expectancy in Europe, says Aleksander Krag.

Europe has some of the highest levels of alcohol consumption in the world, while rates of obesity and diabetes are also rising. This combination increases the risk of both cirrhosis and liver cancer

Many patients are only diagnosed at a late stage, when the disease is already advanced and more difficult to treat. The report therefore highlights the need for earlier detection and more integrated care pathways.

Researchers recommend, among other measures, expanded hepatitis screening and the use of new, less invasive methods to detect liver damage at an earlier stage.

Limited progress since 2021

This is the second report from an international expert group following up on a similar analysis from 2021. The new report concludes that progress has been inadequate and that implementation of recommendations has been insufficient.

– The nearly 300,000 annual deaths are preventable – what is lacking is political courage and action, says Aleksander Krag.

The report’s findings are based on modelling and the synthesis of data from multiple sources, which entails a degree of uncertainty. At the same time, it emphasises that liver disease is closely linked to broader structural and societal factors such as alcohol policy, food environments and social inequality in health. It is therefore not only a matter of treatment, but also of public health policy, prevention and political priorities across Europe.