Wayne David MP, Chair and Margaret Ferrier MP, Vice-Chair of the All-Party Parliamentary Group on Liver Disease and Liver Cancer write for Chamber, in partnership with the British Liver Trust.
Liver disease is one of the leading causes of premature death in the UK. Mortality rates have more than doubled in the last 20 years and are continuing to rise—in stark contrast to other major killer diseases, such as heart disease and cancer, which have remained stable or decreased.
The UK Government lacks a coherent strategy for tackling the worsening liver disease public health crisis and needs to deliver on its commitment to a “full review of adult liver services” by 2023. Figures from the Office for Health Improvement and Disparities (OHID) estimate that liver disease and liver cancer caused 2.5% of deaths in England in 2020 – almost half of which occurred in those of working age (ages 15 to 64).
Liver disease is a silent killer that is largely asymptomatic in its early stages. Due to systemic failures to improve early detection in primary care, three-quarters of people are currently diagnosed in an emergency at a hospital, when it’s too late for effective treatment or intervention. One in four people diagnosed with alcohol-related liver disease in a hospital dies within 60 days.
“Over 10,000 people die from liver disease every year ” —- Wayne David MP
Over 10,000 people die from liver disease every year and liver cancer is now the fastest- rising cause of cancer death in the UK . Yet, 90% of liver disease is preventable. The main risk factors for liver disease are alcohol misuse, obesity and viral hepatitis. The liver has a remarkable ability to regenerate and repair itself. If diagnosed earlier, liver damage can be reversed and risks can be drastically reduced through diet, exercise and drinking in moderation.
Levelling Up Disparities in Liver Disease
Liver disease is a barometer for underlying health inequalities. OHID data highlights the scale of geographic variation and inequalities in liver disease outcomes . Liver disease mortality rates are four times higher in the most deprived areas— in which, individuals are more likely to develop, be hospitalised by, and die from liver disease than the most affluent.
Two- thirds of adults in the UK are overweight, or obese, this placesing millions at risk of non-alcohol- related fatty liver disease (NAFLD) and one in five adults drinks in a way that could cause their liver harm. Increased alcohol consumption during the pandemic caused alcohol-related liver disease deaths to surge by 21% in 2020.
Rural and coastal communities are disproportionately impacted. Blackpool has the worst life expectancy in the UK and the highest premature mortality rate due to liver disease (44.9 per 100,000) in England— – more than double than the national average .
Shockingly, over one- third of all liver disease deaths were reported in the North of England in 2020. In the North East, the liver disease mortality rate was 42% higher than the national average (29.2 per 100,000) and over 80% higher than the East of England (17.1 per 100,000) in 2020.
Postcode Lottery in Early Diagnosis of Liver Disease in Primary Care
We recently formed the All-Party Parliamentary Group on Liver Disease and Liver Cancer to drive action from parliamentarians and policy makers to accelerate earlier diagnosis and improve outcomes for liver disease and liver cancer patients.
Analysis from our Secretariat, the British Liver Trust, published in the British Journal of Medical Practice in October 2021, reveals that only 26% of health bodies (Integrated Care Systems and Health Boards) across the UK have effective patient care pathways for the early diagnosis and management of liver disease.
The stigma associated with alcohol misuse and obesity also hampers early diagnosis. Recent survey findings from the British Liver Trust in August 2022 highlight that almost half (49%) of 1,400 respondents affected by liver disease have faced stigma from healthcare professionals.
Since the parliamentary launch of the ‘make early diagnosis of liver disease routine’ campaign in April, over 30 parliamentarians have engaged with their local health bodies and pockets of good practice are emerging across the UK. Wales has broken ground by launching the All-Wales Liver Blood Test Pathway to improve early detection and the management of liver disease across all seven health boards. However, recent innovations are failing to keep pace with the rising scale of preventable deaths due to liver disease.
The UK Government needs to deliver a prompt and comprehensive review of adult liver services to address the huge variation in care and outcomes. Delivering the levelling-up mission to narrow the gap in healthy life expectancy (HLE) between areas where it is at its highest and lowest, by 2030, demands urgent action to improve the nation’s liver health.
