Screening for advanced steatotic liver disease

IF 38.6 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Lancet Gastroenterology & Hepatology Pub Date : 2025-07-16 DOI:10.1016/s2468-1253(25)00097-4

Stine Johansen, Fredrik Åberg, Emmanuel A Tsochatzis, Aleksander Krag

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Abstract

Steatotic liver disease often progresses asymptomatically, with the risk of advancing to cirrhosis and liver cancer. Early detection of advanced liver disease through screening presents an opportunity to prevent severe outcomes, if said screening is linked to effective intervention. This Review evaluates the feasibility of screening for advanced steatotic liver disease through the lens of the Wilson and Jungner criteria. The assessment focuses on the presence of a presymptomatic stage as a target for screening, advances in diagnostic tests, cost-effectiveness, the availability of effective treatments, and the difficult task of balancing harms against benefits of screening. Additional criteria are proposed to address contemporary challenges, including ensuring equitable access, implementing long-term programme evaluation, and developing strategies to minimise psychosocial harm. The long-term benefits of screening—particularly in reducing liver-related morbidity and mortality remain unclear—highlighting the need for large-scale randomised trials with long-term follow-up.

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晚期脂肪变性肝病筛查

脂肪变性肝病通常无症状进展，有发展为肝硬化和肝癌的危险。如果筛查与有效干预相联系，通过筛查早期发现晚期肝病提供了预防严重后果的机会。本综述通过Wilson和Jungner标准评估晚期脂肪变性肝病筛查的可行性。评估的重点是作为筛查目标的症状前阶段的存在、诊断测试的进展、成本效益、有效治疗的可得性，以及平衡筛查的危害和益处的艰巨任务。提出了其他标准以应对当前的挑战，包括确保公平获取、实施长期规划评估和制定战略以尽量减少社会心理伤害。筛查的长期益处，特别是在降低肝脏相关发病率和死亡率方面的益处尚不清楚，这强调了长期随访的大规模随机试验的必要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Lancet Gastroenterology & Hepatology Medicine-Hepatology

CiteScore

50.30

自引率

1.10%

发文量

期刊介绍： The Lancet Gastroenterology & Hepatology is an authoritative forum for key opinion leaders across medicine, government, and health systems to influence clinical practice, explore global policy, and inform constructive, positive change worldwide. The Lancet Gastroenterology & Hepatology publishes papers that reflect the rich variety of ongoing clinical research in these fields, especially in the areas of inflammatory bowel diseases, NAFLD and NASH, functional gastrointestinal disorders, digestive cancers, and viral hepatitis.