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ILC 2021 Takeaways – Public health • As part of the International Liver Congress (ILC) 2021, the EASL Takeaways take a look at key topics from the congress, with leading experts discussing the most impactful science and putting it into perspective. This session, presented by Professors Maria Buti, Shira Zelber-Sagi and Antonio Craxì, explores prominent themes from ILC 2021 on the topic of public health. Professor Zelber-Sagi takes the panel through the importance of public health policies in tackling obesity, particularly in populations with low socioeconomic status. They examine the associations between food insecurity and all-cause mortality in adults with liver disease, between parental pre-pregnancy BMI and offspring NAFLD, and between obesity and loss to follow-up in cirrhotic populations. The panel then reviews the impact of the COVID-19 pandemic on liver care, as well as the effect of liver disease on COVID-19 mortality. Finally, Professor Craxì discusses residual mortality in HBV carriers and the effects of HBV vaccines on liver cancer prevention.
Liver Cancer Explained • Liver cancer is the third leading cause of cancer-related deaths worldwide and the primary cause of death for patients with cirrhosis. Most of liver cancers are hepatocellular carcinomas, however some patients develop intrahepatic cholangiocarcinomas (ICC) or rare tumours in non-cirrhotic livers. Chronic liver diseases, alcohol consumption, obesity and diabetes, non-alcoholic fatty liver disease (NAFLD), exposure to aflatoxins, as well as chronic infection with HBV or HCV are considered risk factors. The burden of adult liver cancers and HCC is still increasing and various public health strategies have been developed for the prevention and control of this trend which will likely remain a major public health problem worldwide in the upcoming decades. Discover the infographic below illustrating key information for a better understanding of liver cancer. Liver Cancer Explained Infographic
Metabolism, Alcohol & Toxicity
Reducing the burden of alcohol-related liver disease (ARLD) • ARLD is responsible for nearly 40,000 deaths in Europe every year and alcohol consumption is directly correlated with liver disease mortality in most EU countries. It is largely a ‘silent’ illness, in 75% of cases, it is not identified until the patient is in the emergency room, with heavy drinkers at exponentially higher risk of cirrhosis. To address this growing problem, EASL is calling on all European countries to limit alcohol consumption and increase disease detection by implementing five key recommendations. In doing so, we can all reduce the personal and economic burden of ARLD.
Metabolism, Alcohol & Toxicity
Obesity and non-alcoholic fatty liver disease (NAFLD) • NAFLD is one of the most common causes of cirrhosis, liver transplant and liver cancer worldwide. Its prevalence is rising, in line with that of risk factors such as obesity and unhealthy lifestyles. There are no licenced medications for NAFLD, but it can be avoided and successfully treated by making lifestyle modifications including healthy eating and increased exercise. To mitigate the societal burden of NAFLD, EASL is calling on all European countries to adopt key policy changes which discourage consumption while improving health education and awareness. We can all do our part to reduce the risk of NAFLD.
Eliminating hepatitis C • Despite the ability of new direct-acting antiviral therapies to cure hepatitis C in almost all treated patients, HCV is still responsible for 400,000 deaths worldwide every year. Not only do patients face a number of barriers to treatment, but infection is largely asymptomatic until its later stages, leading to cirrhosis and liver cancer. To tackle the challenge of HCV, EASL is calling on all European countries to implement the WHO Global Health Sector Strategy on Viral Hepatitis action plan. EASL and the WHO believe that HCV can be eliminated as a public health threat by 2030, but we need to work together and take action now.