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Review
. 2022 Jan;75(1):219-228.
doi: 10.1002/hep.32163. Epub 2021 Dec 10.

Population screening for liver fibrosis: Toward early diagnosis and intervention for chronic liver diseases

Pere Ginès  1   2   3   4 , Laurent Castera  5   6   7 , Frank Lammert  8   9   10 , Isabel Graupera  1   2   3   4 , Miquel Serra-Burriel  11 , Alina M Allen  12 , Vincent Wai-Sun Wong  13 , Phillipp Hartmann  14 , Maja Thiele  15 , Llorenç Caballeria  16 , Robert J de Knegt  17 , Ivica Grgurevic  18 , Salvador Augustin  3   19   20 , Emmanuel A Tsochatzis  21 , Jörn M Schattenberg  22 , Indra Neil Guha  23 , Andrea Martini  24 , Rosa M Morillas  3   20   25 , Montserrat Garcia-Retortillo  26 , Harry J de Koning  27 , Núria Fabrellas  2   28 , Judit Pich  29 , Ann T Ma  1   2   4 , M Alba Diaz  30 , Dominique Roulot  31 , Philip N Newsome  32   33 , Michael Manns  8 , Patrick S Kamath  12 , Aleksander Krag  15 ; LiverScreen Consortium Investigators
Affiliations
Review

Population screening for liver fibrosis: Toward early diagnosis and intervention for chronic liver diseases

Pere Ginès et al. Hepatology. 2022 Jan.

Abstract

Cirrhosis, highly prevalent worldwide, develops after years of hepatic inflammation triggering progressive fibrosis. Currently, the main etiologies of cirrhosis are non-alcoholic fatty liver disease and alcohol-related liver disease, although chronic hepatitis B and C infections are still major etiological factors in some areas of the world. Recent studies have shown that liver fibrosis can be assessed with relatively high accuracy noninvasively by serological tests, transient elastography, and radiological methods. These modalities may be utilized for screening for liver fibrosis in at-risk populations. Thus far, a limited number of population-based studies using noninvasive tests in different areas of the world indicate that a significant percentage of subjects without known liver disease (around 5% in general populations and a higher rate -18% to 27%-in populations with risk factors for liver disease) have significant undetected liver fibrosis or established cirrhosis. Larger international studies are required to show the harms and benefits before concluding that screening for liver fibrosis should be applied to populations at risk for chronic liver diseases. Screening for liver fibrosis has the potential for changing the current approach from diagnosing chronic liver diseases late when patients have already developed complications of cirrhosis to diagnosing liver fibrosis in asymptomatic subjects providing the opportunity of preventing disease progression.

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