Liver disease rises in England while falling elsewhere in Europe, report says

BMJ 2012; 345 doi: (Published 21 November 2012) Cite this as: BMJ 2012;345:e7931
  1. Gareth Iacobucci
  1. 1BMJ

The chief medical officer for England has called for urgent action to stem the surge in cases of liver disease.

In her first annual report, published today, Sally Davies said that tackling the rising incidence of chronic liver disease and cirrhosis was a pressing priority.1 Cases rose by around 20% in people aged under 65 between 2000 and 2009 in England but fell by the same amount in most European Union countries.

The report, which has collated a range of data to provide a detailed picture of the nation’s health, says that a failure to tackle the three main causes of liver disease—­obesity, undiagnosed infection, and, increasingly, harmful drinking—had led to England being one of the few countries in the EU where a major cause of preventable death is on the increase.

Other headlines in the report, which aims to steer the priorities for action by local authorities and Public Health England in local populations, include the finding that people who live the longest spend the shortest amount of time with limiting long term illnesses such as heart disease, diabetes, or osteoporosis.

In the under 75s in 2010 727 000 years of life were lost to cancer, with 20% of these being due to lung cancer, the single biggest cause in this age group.

Around a third of adults in England are recorded as having three or more risk factors for poor health, such as raised cholesterol concentrations, diabetes, or overweight, a proportion that rose to around 40% of adults in the most deprived areas.

The report recommends several ways to improve the monitoring and process of care for key conditions such as heart disease, obesity, and cancer. These include improving the proportion (currently 50%) of people registered as diabetic who currently receive the full range of annual recommended checks; ensuring that the capturing of data on long term conditions is as strong as current surveillance of the causes of early death; and increasing survival from cancers such as lung and pancreatic cancer.

Davies also urged health professionals to focus on tackling the medical risk factors linked to life limiting diseases, such as smoking, harmful alcohol consumption, and poor diet.

In a press release 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.”

Commenting on the focus on liver disease and alcohol misuse, Richard Thompson, president of the Royal College of Physicians, said, “We echo the CMO’s concerns, which could not come at a better time as we await the government’s decision on the most appropriate level for a minimum price for alcohol.”2

He added, “These figures underline the urgent need for a 50p [€0.6; $0.8] minimum unit price for alcohol, which would hit younger drinkers and heavy drinkers, while not greatly affecting moderate drinkers.”

A second volume of the report, examining infections in more detail, will be published early next year.


Cite this as: BMJ 2012;345:e7931