Researchers from King's are co-authors on a major new report from the European Association for the Study of the Liver (EASL)-Lancet Commission on Liver Health in Europe, which warns that liver disease is an escalating public health crisis across the WHO European Region.
Every day in Europe, nearly 780 people die from cirrhosis or liver cancer - conditions that are largely preventable. The report calls on governments to implement stronger prevention policies and integrate liver health into broader non-communicable disease (NCD) strategies.
The EASL-Lancet Commission on Liver Health in Europe brings together leading experts in hepatology, public health, mental health, economics, patient representatives, and health policy to assess the burden of liver disease and propose evidence-based strategies to improve liver health across the region. The Commission's first report was published in 2021.
The Commission's second report, From Evidence to Impact: Implementing Sustainable Liver Health in Europe, finds that cirrhosis and liver cancer together account for approximately 284,000 deaths annually in Europe. Liver cancer mortality has increased by more than 50% since 2000 - from around 43,000 deaths to approximately 69,000 in 2023. Crucially, liver disease remains one of the few major NCDs still growing, even as Europe has made progress against conditions like heart disease and cancer.
The report also looked at the economic impact of liver disease. The data show that in the absence of liver disease, the combined economies of EU countries and associated European states would be larger by approximately €55 billion annually, with liver disease reducing GDP by around 0.3% across the region - a direct reflection of lost productivity, premature death and workforce absence.
Professors Debbie Shawcross and Phil Newsome from the Roger Williams Institute of Liver Studies at King's are co-authors on the report.
Liver disease is no longer a silent condition - it is a growing public health failure that we have the tools to prevent. What is missing is not evidence, but action. Europe now has a clear opportunity to turn the tide, but this will require political courage to address the root causes of disease and put health ahead of harmful commercial interests.
Debbie Shawcross, Professor of Hepatology and Chronic Liver Failure at King's
According to the report, alcohol consumption and obesity, alongside viral hepatitis, remain the principal causes of liver-related mortality in Europe. The prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) continues to rise, driven by obesity, unhealthy diets and alcohol use.
These risks are strongly shaped by commercial determinants of health - the marketing, pricing and availability of alcohol and unhealthy foods - highlighting the need for stronger industry regulation and policies that create healthier environments, the Commission states.
A call for coordinated policy action
The Commission calls on European governments, the European Union, and the World Health Organization to place liver health firmly within the region's NCD agenda. Key recommendations include:
- Introducing health warning labels on alcohol products and restricting digital marketing, particularly to young people
- Acting on commercial determinants of health through stronger regulation of alcohol and ultra-processed food marketing and taxation
- Expanding viral hepatitis testing and care for migrants and underserved populations
- Strengthening integrated care models across primary care, specialist services, and community settings
- Integrating liver health into national and global NCD strategies, recognising steatotic liver disease as a preventable NCD
- Improving access to affordable medicines through joint procurement and pricing cooperation among EU Member States
- Integrating liver health metrics into existing NCD monitoring frameworks to ensure accountability
Priorities for progress
Despite strong health systems and a track record of effective public health action, such as tobacco control, liver disease remains one of the few major NCDs still increasing.
The Commission identifies three priorities for meaningful progress:
- Make liver disease a top health priority, and include it in national and European health plans
- Detect and treat liver disease earlier, with joined-up care for people who often have multiple health conditions
- Tackle the root causes, including alcohol, unhealthy food, and other factors shaped by industry and the wider environment
Liver disease is a disease of inequality, and the burden falls hardest on those least able to bear it. Our work at the Roger Williams Institute of Liver Studies, alongside the British Liver Trust, reflects what this Commission demands - earlier detection, joined-up care and the resolve to act on what we already know works.
Phil Newsome, Professor of Hepatology and Director of the Roger Williams Institute of Liver Studies at King's
