The burden of liver disease in Europe. A review of available epidemiological data.
TL;DR: To survey the burden of liver disease in Europe and its causes 260 epidemiological studies published in the last five years were reviewed and found each of these four major causes is amenable to prevention and treatment.
About: This article is published in Journal of Hepatology.The article was published on 2013-03-01 and is currently open access. It has received 1052 citations till now. The article focuses on the topics: Liver disorder & European union.
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TL;DR: A narrative review focuses on the rapidly expanding body of clinical evidence that supports the concept of NAFLD as a multisystem disease and the factors linkingNAFLD with other extra-hepatic chronic diseases, such as T2DM, CVD, cardiac diseases and CKD.
1,897 citations
Cites background from "The burden of liver disease in Euro..."
...Current populationbased prevalence of NAFLD is approximately 30–40% in men and 15–20% in women [4] and is even higher in people with type 2 diabetes mellitus (T2DM), occurring in up to 70% of this group of patients [5]....
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01 Jan 2013
TL;DR: The EASL CPGs on the management of HCV infection will be updated on a regular basis upon approval of additional novel therapies, and will apply to therapies that are approved at the time of their publication.
Abstract: Hepatitis C virus (HCV) infection is one of the main causes of chronic liver disease worldwide [1]. The long-term hepatic impact of HCV infection is highly variable, from minimal changes to chronic hepatitis, extensive fibrosis, and cirrhosis with or without hepatocellular carcinoma (HCC). The number of chronically infected persons worldwide may exceed 200 million, but most of them have no knowledge of their infection or of the ensuing hepatic condition. Clinical care for patients with HCV-related liver disease has advanced considerably during the last two decades, as a result of growing knowledge about the mechanisms of the disease, remarkable developments in diagnostic procedures, and advances in therapeutic and preventative approaches. Still, various aspects are not yet completely resolved. These EASL Clinical Practice Guidelines (CPGs) are intended to assist physicians and other healthcare providers, as well as patients and interested individuals, in the clinical decision-making process by describing optimal management of patients with acute and chronic HCV infections. These guidelines apply to therapies that are approved at the time of their publication. Several new therapeutic options have completed phase III development for patients infected with HCV genotype 1 and are currently awaiting licensing and approval in Europe and the United States. Therefore, the EASL CPGs on the management of HCV infection will be updated on a regular basis upon approval of additional novel therapies.
1,407 citations
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TL;DR: The set-up and results of the Liver Tumor Segmentation Benchmark (LITS) organized in conjunction with the IEEE International Symposium on Biomedical Imaging (ISBI) 2016 and International Conference on Medical Image Computing Computer Assisted Intervention (MICCAI) 2017 are reported.
Abstract: In this work, we report the set-up and results of the Liver Tumor Segmentation Benchmark (LITS) organized in conjunction with the IEEE International Symposium on Biomedical Imaging (ISBI) 2016 and International Conference On Medical Image Computing Computer Assisted Intervention (MICCAI) 2017. Twenty four valid state-of-the-art liver and liver tumor segmentation algorithms were applied to a set of 131 computed tomography (CT) volumes with different types of tumor contrast levels (hyper-/hypo-intense), abnormalities in tissues (metastasectomie) size and varying amount of lesions. The submitted algorithms have been tested on 70 undisclosed volumes. The dataset is created in collaboration with seven hospitals and research institutions and manually reviewed by independent three radiologists. We found that not a single algorithm performed best for liver and tumors. The best liver segmentation algorithm achieved a Dice score of 0.96(MICCAI) whereas for tumor segmentation the best algorithm evaluated at 0.67(ISBI) and 0.70(MICCAI). The LITS image data and manual annotations continue to be publicly available through an online evaluation system as an ongoing benchmarking resource.
533 citations
Cites background from "The burden of liver disease in Euro..."
...Instead of measuring diameters of target lesions, a fully volumetric segmentation of both liver and its lesion and the subsequent tumor burden analysis offers valuable insights of the disease progression [15]....
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TL;DR: This review will analyze the most relevant established and/or emerging pathophysiological issues underlying CLD progression with a focus on the role of critical hepatic cell populations, mechanisms and signaling pathways involved, as they represent potential therapeutic targets to finally analyze selected and relevant clinical issues.
479 citations
TL;DR: Screening for NASH in the general population is not currently recommended due to the lack of a reliable and accepted non-invasive diagnostic modality and better understanding of the natural history of NASH is needed to evaluate the utility and cost-effectiveness of screening.
Abstract: Non-alcoholic steatohepatitis (NASH) is part of the spectrum of non-alcoholic fatty liver disease (NAFLD) that leads to progressive liver disease and presents a growing challenge to public health. Because of the increased prevalence of metabolic syndrome and obesity, NAFLD and NASH have expanded to a substantial extent. In NASH patients, advanced fibrosis is the major predictor of morbidity and liver-related mortality, and an accurate diagnosis of NASH is mandatory. Although there is currently no validated test of serum biomarkers available to diagnose NASH, and histologic evaluation with a liver biopsy remains the gold standard, screening for fibrosis is recommended in patients with suspicion of NASH. Clinical prediction models and serum biomarkers for advanced fibrosis have relatively good negative predictive value and can be useful for screening. Also, transient elastography is increasingly available to estimate fibrosis in NASH. Therefore, due to the lack of a reliable and accepted non-invasive diagnostic modality, screening for NASH in the general population is not currently recommended. Better understanding of the natural history of NASH is needed to evaluate the utility and cost-effectiveness of screening.
380 citations
References
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TL;DR: The total number of new cases of cancer in Europe appears to have increased by 300,000 since 2004 and the ageing of the European population will cause these numbers to continue to increase even if age-specific rates remain constant.
4,155 citations
TL;DR: GLOBOCAN 2000 updates the previous data-based global estimates of incidence, mortality and prevalence to the year 2000 and uses a “databased” approach, rather different from themodeling method used in other estimates.
Abstract: Describing the distribution of disease between different populations and over time has been ahighly successfu l way of devising hypothese s about causation and for quantifying the potential for preventive activities.1 Statistical data are also essentia l componentsof diseasesurveillanceprograms. Theseplay acritical role in the developmen t and implementation of health policy, through identification of health problems, decisions on priorities for preventive and curative programs and evaluation of outcomes of programs of prevention, early detection/screenin g and treatment in relation to resource inputs. Over the last 12 years, aseries of estimates of the global burden of cancer have been published in the International Journal of Cancer. 2–6 The methods have evolved and been refined, but basically they rely upon the best availabl e data on cancer incidence and/or mortality at country level to build up theglobal picture. The results are more or less accurat e for different countries, depending on the extent and accuracy of locally availabl e data. This “databased” approach is rather different from themodeling method used in other estimates. 7–10 Essentially, these use sets of regression models, which predict cause-specifi c mortality rates of different populations from the correspondin g all-cause mortality.11 The constant s of the regression equations derive from dataset s with different overal mortality rates (often including historic data from wester n countries) . Cancer deaths are then subdivided into the different cancer types, according to the best availabl e information on relative frequencies. GLOBOCAN 2000 updates thepreviousl y published data-based global estimates of incidence, mortality and prevalence to the year 2000.12
3,748 citations
TL;DR: The incidence of primary liver cancer is increasing in several developed countries, including the United States, and the increase will likely continue for some decades, the trend is a result of a cohort effect related to infection with hepatitis B and C viruses.
2,402 citations
"The burden of liver disease in Euro..." refers background in this paper
...In recent years decreasing incidence has been reported in some high incidence countries, while significant increases have been reported in several low incidence countries [6,9,10]....
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TL;DR: The statistical models used used to estimate incidence and mortality data for 25 cancers in 40 European countries in 2008 used to obtain an estimate of the numbers of cancer cases and deaths in Europe in 2008.
2,358 citations