Disease burden and costs from excess alcohol consumption, obesity, and viral hepatitis: fourth report of the Lancet Standing Commission on Liver Disease in the UK

The Lancet
Volume 391, Issue 10125, 2018, Pages 1097-1107

Disease burden and costs from excess alcohol consumption, obesity, and viral hepatitis: fourth report of the Lancet Standing Commission on Liver Disease in the UK (Note)

Williams R.* , Alexander G. , Armstrong I. , Baker A. , Bhala N. , Camps-Walsh G. , Cramp M.E. , de Lusignan S. , Day N. , Dhawan A. , Dillon J. , Drummond C. , Dyson J. , Foster G. , Gilmore I. , Hudson M. , Kelly D. , Langford A. , McDougall N. , Meier P. , Moriarty K. , Newsome P. , O'Grady J. , Pryke R. , Rolfe L. , Rice P. , Rutter H. , Sheron N. , Taylor A. , Thompson J. , Thorburn D. , Verne J. , Wass J. , Yeoman A.

^a Foundation for Liver Research, The Institute of Hepatology, London, United Kingdom
^b British Association for the Study of the Liver, United Kingdom
^c Public Health England, United Kingdom
^d King's College Hospital, London, United Kingdom
^e Queen Elizabeth Hospital Birmingham, Birmingham, United Kingdom
^f Medical Marketing Consultants, Oxford, United Kingdom
^g Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, United Kingdom
^h Royal College of General Practitioners Research and Surveillance Centre, University of Surrey, Surrey, United Kingdom
ⁱ Foundation for Liver Research, The Institute of Hepatology, London, United Kingdom
^j King's College Hospital, London, United Kingdom
^k Medical Research Institute, University of Dundee, Dundee, United Kingdom
^l Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
^m Freeman Hospital, Newcastle, United Kingdom
ⁿ Queen Mary University of London, London, United Kingdom
^o University of Liverpool, Liverpool, United Kingdom
^p Freeman Hospital, Newcastle, United Kingdom
^q Birmingham Children's Hospital, Birmingham, United Kingdom
^r British Liver Trust, United Kingdom
^s Belfast Health and Social Care Trust, Belfast, United Kingdom
^t Section of Public Health, The School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
^u Royal Bolton Hospital, Bolton, United Kingdom
^v National Institute for Health Research (NIHR) Biomedical Research Centre, University of Birmingham, Birmingham, United Kingdom
^w King's College Hospital, London, United Kingdom
^x Winyates Health Centre, Redditch, United Kingdom
^y Public Health England, United Kingdom
^z Scottish Health Action on Alcohol Problems, Edinburgh, United Kingdom
^a London School of Hygiene & Tropical Medicine, London, United Kingdom
^b NIHR Southampton Biomedical Research Centre, University of Southampton, Southampton, United Kingdom
^c Children's Liver Disease Foundation, United Kingdom
^d Fulcrum Practice, Middlesbrough, United Kingdom
^e Royal Free Hospital, London, United Kingdom
^f Public Health England, United Kingdom
^g Oxford University, Oxford, United Kingdom
^h Aneurin Bevan University Health Board, Newport, United Kingdom

Abstract

This report contains new and follow-up metric data relating to the eight main recommendations of the Lancet Standing Commission on Liver Disease in the UK, which aim to reduce the unacceptable harmful consequences of excess alcohol consumption, obesity, and viral hepatitis. For alcohol, we provide data on alcohol dependence, damage to families, and the documented increase in alcohol consumption since removal of the above-inflation alcohol duty escalator. Alcoholic liver disease will shortly overtake ischaemic heart disease with regard to years of working life lost. The rising prevalence of overweight and obesity, affecting more than 60% of adults in the UK, is leading to an increasing liver disease burden. Favourable responses by industry to the UK Government's soft drinks industry levy have been seen, but the government cannot continue to ignore the number of adults being affected by diabetes, hypertension, and liver disease. New direct-acting antiviral drugs for the treatment of chronic hepatitis C virus infection have reduced mortality and the number of patients requiring liver transplantation, but more screening campaigns are needed for identification of infected people in high-risk migrant communities, prisons, and addiction centres. Provision of care continues to be worst in regions with the greatest socioeconomic deprivation, and deficiencies exist in training programmes in hepatology for specialist registrars. Firm guidance is needed for primary care on the use of liver blood tests in detection of early disease and the need for specialist referral. This report also brings together all the evidence on costs to the National Health Service and wider society, in addition to the loss of tax revenue, with alcohol misuse in England and Wales costing £21 billion a year (possibly up to £52 billion) and obesity costing £27 billion a year (treasury estimates are as high as £46 billion). Voluntary restraints by the food and drinks industry have had little effect on disease burden, and concerted regulatory and fiscal action by the UK Government is essential if the scale of the medical problem, with an estimated 63 000 preventable deaths over the next 5 years, is to be addressed. © 2018 Elsevier Ltd

Author Keywords

[No Keywords available]

Index Keywords

primary medical care Alcohol Drinking drinking behavior food industry economics health care policy alcohol consumption complication follow up patient identification human diabetes mellitus obesity priority journal hypertension chronic hepatitis C Note soft drink liver disease alcohol liver disease public health campaign national health service virus hepatitis health care cost Health Care Costs Humans family Wales England patient referral tax cost of illness socioeconomics liver transplantation diagnostic test prevalence prison blood analysis United Kingdom medical specialist Hepatitis, Viral, Human government ischemic heart disease addiction antivirus agent disease burden beverage high risk patient mortality Liver Diseases, Alcoholic early diagnosis

Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85036528329&doi=10.1016%2fS0140-6736%2817%2932866-0&partnerID=40&md5=3749240f6c06f30452b5518f502fcbcd

DOI: 10.1016/S0140-6736(17)32866-0

ISSN: 01406736

Cited by: 36

Original Language: English