Awareness, access, and community-driven screening may answer the unmet need of the underestimated rates of chronic liver disease in the US. Earlier detection is imperative to treat liver disease, so that clinicians can recommend lifestyle modifications, medications, and monitoring to halt damage and even reverse early-stage scarring.
Why Do Clinicians Need To Screen or Recognize Liver Disease Earlier?
“The liver is a vital organ capable of repairing itself,” Steven Gonzalez, MD, MS, Director of Liver Transplantation at Baylor Scott & White Health, said in an interview with HCPLive to discuss his talk, Approaching Liver Health Through a Community Health Lens and Early Identification from the 2026 Liver Health Symposium, hosted by the Global Liver Institute. “ In many of these conditions [fatty liver disease, metabolic dysfunction-associated steatotic liver disease (MASLD), alcohol-related liver disease, and even viral hepatitis], even if a person does have evidence of advancing or progressive liver disease, you can actually avoid cirrhosis, and the liver can actually return to improved function and move further away from cirrhosis.”
What’s the Reality of Liver Disease in The US?
An estimated 1.5% of the US’s adult population have chronic liver disease or cirrhosis, with mortality rates having nearly doubled since 1999. The most prominent underlying drivers of chronic liver disease include metabolic syndrome, chronic alcohol use, and viral hepatitis, particularly Hepatitis C.
Patient Populations Disproportionately Impacted by Liver Disease
Gonzalez emphasized that many chronic liver diseases disproportionately affect populations that may face barriers to accessing healthcare.
He pointed to hepatitis C as one example, noting that the disease disproportionately affects individuals who may not regularly seek medical care, including people experiencing homelessness, those who are incarcerated, and individuals with a history of injection drug use.
He added that MASLD can also be associated with social determinants of health, including food insecurity and limited access to resources that support healthy lifestyles and preventive care.
Gonzalez also highlighted the importance of targeted screening efforts. He noted that individuals from countries where hepatitis B is endemic should be screened for infection.
Other groups who may benefit from evaluation include people with diabetes, obesity, high cholesterol, high blood pressure, a family history of liver disease, or a history of excessive alcohol use.
“You need to really outreach to those communities in an effort to reduce the burden of liver disease in the US,” Gonzalez said.
Editor’s Note: Gonzalez reports relevant disclosures with Mallinckrodt Pharmaceuticals, Salix, AbbVie, Gilead, and others.
References
Alqahtani, S. A., Paik, J. M., Biswas, R., Arshad, T., Henry, L., & Younossi, Z. M. (2021). Poor Awareness of Liver Disease Among Adults With NAFLD in the United States. Hepatology Communications, 5(11), 1833–1847. https://doi.org/10.1002/hep4.1765