The study is part of the European LIVERSCREEN project, funded by the Horizon 2020 programme and promoted and coordinated by IDIBAPS. It is the largest population‑based liver fibrosis screening study conducted to date. Nearly 30,000 individuals aged over 40 from nine European countries were assessed using FibroScan, a non‑invasive technique that measures liver stiffness and allows fibrosis to be estimated without the need for a biopsy.
The results show that 1.6% of the population studied had previously undiagnosed liver disease with fibrosis, a relevant figure given the absence of symptoms and the fact that this was a general population sample. In the initial screening phase, 4.6% of participants showed elevated FibroScan values suggestive of fibrosis and were referred to hospital for specialised confirmatory testing. In the diagnostic confirmation phase, 32% of those assessed in hospital were found to have chronic liver disease with fibrosis, representing approximately 1.6% of the total population analysed.
“Having methods to identify fibrosis at an early stage has major implications for patients and society, as it allows the disease to be detected in its initial phases, risk factors to be addressed, and therapeutic or preventive measures to be implemented before irreversible damage occurs,” explains Pere Ginès, project leader, senior consultant in the Hepatology Department at Hospital Clínic, Professor of Medicine at the University of Barcelona, and head of the Chronic Liver Diseases group at IDIBAPS and CIBEREHD.
Chronic liver disease is the leading cause of premature death worldwide, and fibrosis is the main determinant of disease progression. Liver fibrosis can develop silently over decades and is often not detected until cirrhosis with irreversible complications eventually develops.
Diabetes, obesity and alcohol consumption are key drivers of liver fibrosis
The study also analysed in detail the role of risk factors such as obesity, type 2 diabetes, hypertension, dyslipidaemia and harmful alcohol consumption. The data show that these factors not only increase the prevalence of liver fibrosis and the risk of chronic liver disease, but that when they coexist, they exponentially increase the likelihood of developing the condition.
“For the first time, our results provide an accurate picture of how liver disease risk is distributed across Europe. This is essential for designing more efficient screening strategies, tailored to the needs of each country and focused on populations at higher risk,” says Isabel Graupera, first author of the article, senior specialist in the Hepatology Department at Hospital Clínic and researcher at IDIBAPS.
Metabolic risk factors or alcohol consumption are present in more than 70% of the population. “Given the high prevalence of these factors, screening approaches should extend beyond narrowly defined high‑risk groups and include a broad segment of the population,” adds Ginès.
Study reference:
Graupera I, Thiele M, Castera L et al. Prevalence of liver fibrosis in the general population (the LiverScreen project): a multinational European cohort study. The Lancet, 407, 1448-1458
