title: Screening for liver fibrosis in the general population: a call for action.
abstract: Liver cirrhosis is one of the main causes of death and disability-adjusted life-years worldwide. Generally, cirrhosis develops after a long period of liver-cell injury that leads to the deposition of collagen, leading to progressive fibrosis and nodule formation in the liver tissue. Most patients are diagnosed in late stages when liver decompensation or liver cancer develops. The diagnosis is rarely made in early stages-when liver fibrosis is mild to moderate but cirrhosis is not yet established-because the disease is asymptomatic. No strategies for detection of liver fibrosis at these early stages have been developed, but therapies are more effective in early stages than late stages of chronic liver diseases, so enabling early detection is an important research topic. Non-invasive methods for assessing liver fibrosis have been developed, of which the most commonly used are transient elastography-which estimates liver fibrosis by measuring liver stiffness-and serum biomarkers of fibrosis. Studies have shown that 6-7% of the adult population without known liver disease have liver fibrosis, mostly associated with non-alcoholic fatty liver disease. These data suggest that programmes of screening for liver fibrosis in the general population should be assessed.
authors.affiliation: Liver Unit, Hospital Clinic, Universitat de Barcelona, Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), Barcelona, Spain; Centro d'Investigaciones Biomedicas en Red, Enfermedades Hepatologia y Digestivas (CIBEReHD), Barcelona, Spain. Electronic address: pgines@clinic.cat.
authors.forename: Pere
authors.initials: P
authors.lastname: Ginès
authors.affiliation: Liver Unit, Hospital Clinic, Universitat de Barcelona, Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), Barcelona, Spain; Centro d'Investigaciones Biomedicas en Red, Enfermedades Hepatologia y Digestivas (CIBEReHD), Barcelona, Spain.
authors.forename: Isabel
authors.initials: I
authors.lastname: Graupera
authors.affiliation: Department of Medicine II, Saarland University Medical Center, Homburg, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Lammert
authors.affiliation: Unit of Hepatic Emergencies and Liver Transplantation, Department of Medicine (DIMED), University of Padova, Padova, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Angeli
authors.affiliation: Centro d'Investigaciones Biomedicas en Red, Enfermedades Hepatologia y Digestivas (CIBEReHD), Barcelona, Spain; Unitat de Suport a la Recerca (USR) Metropolitana Nord, Institut d'Investigació en Atenció Primària (IDIAP) Jordi Gol, Barcelona, Spain.
authors.forename: Llorenç
authors.initials: L
authors.lastname: Caballeria
authors.affiliation: Department of Gastroenterology and Hepatology, Odense Patient data Exploratory Network (OPEN), Odense University Hospital, Odense, Denmark.
authors.forename: Aleksander
authors.initials: A
authors.lastname: Krag
authors.affiliation: NIHR Nottingham Digestive Diseases Biomedical Research Unit, University of Nottingham, Nottingham, UK.
authors.forename: I Neil
authors.initials: IN
authors.lastname: Guha
authors.affiliation: Department of Gastroenterology and Hepatology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands.
authors.forename: S Darwish
authors.initials: SD
authors.lastname: Murad
authors.affiliation: Department of Hepatology, Hôpital Beaujon, Assistance Publique-Hôpitaux de Paris, Clichy, France; Université Paris VII, INSERM UMR 1149, Centre de Recherche sur l'Inflammation, Paris, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Castera
mesh_terms: D015415:Biomarkers / Q000097:blood; D002908:Chronic Disease; D042241:Early Diagnosis; D054459:Elasticity Imaging Techniques; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood / Q000175:diagnosis*; D008403:Mass Screening / Q000379:methods*
chemical_list: D015415:Biomarkers