Action needed on liver disease, alcohol – Chief Medical Officer

Comprehensive action is needed to stop the rising tide of liver disease, this is one of the key findings to emerge from Chief Medical Officer Professor Dame Sally Davies first annual report on the state of the public health.

The report, which is the first of two volumes, provides a comprehensive picture of England’s health by bringing together a number of data sources in one place for the first time. Liver disease and, therefore, alcohol are necessarily highlighted in the report because England is one of the few countries in the European Union where this major cause of preventable death is on the increase.

Between 2000 and 2009, deaths from chronic liver disease and cirrhosis in the under 65s increased by around 20 per cent while they fell by the same amount in most EU countries. And all three major causes of liver disease – obesity, undiagnosed infection, and, increasingly, harmful drinking – are preventable. However, the report states, 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.

Professor Dame Sally Davies said:

“I have done a comprehensive analysis of the state of the country’s health, and found some areas where we are doing really well and others where there is still a lot of improvement needed.

“I was struck by the data on liver disease particularly. This is the only major cause of preventable death that is on the increase in England that is generally falling in other comparable European nations. We must act to change this.....”

“... 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. 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.

Recommendation

Action on preventing, identifying and treating liver disease is a priority and needs to be included in local health and wellbeing strategies.”