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Review
. 2022 Dec 28;13(1):91.
doi: 10.3390/diagnostics13010091.

Screening for Liver Fibrosis in the General Population: Where Do We Stand in 2022?

Clémence M Canivet  1   2 , Jérôme Boursier  1   2
Affiliations
Review

Screening for Liver Fibrosis in the General Population: Where Do We Stand in 2022?

Clémence M Canivet et al. Diagnostics (Basel). .

Abstract

Approximately 30% of the worldwide population has at least one risk factor for liver disease. Identifying advanced liver disease before the occurrence of complications remains a difficult challenge in clinical practice, where diagnosis comes too late for many patients, at the time of liver decompensation or palliative hepatocellular carcinoma, with poor short-term prognosis. Noninvasive, blood- or elastography-based tests of liver fibrosis (NITs) have been developed for the early diagnosis of advanced liver fibrosis. Recent population-based studies evaluating the screening of liver fibrosis with these NITs have provided important information on at-risk groups that should be targeted. New measures based on the sequential use of NITs help to better organize the referral of at-risk patients to the liver specialist. However, energizing these measures will require increased awareness of both chronic liver diseases and the use of NITs among non-specialists.

Keywords: FIB-4; NAFLD; advanced fibrosis; liver fibrosis; noninvasive liver fibrosis test; primary care.

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Conflict of interest statement

J.B. reports consulting activities with Echosens. C.M.C reports no conflict of interest.

Figures

Figure 1
Figure 1
Referral pathway proposed by the European Association for the Study of the Liver (EASL), the American Gastroenterology Association (AGA), and the American Association for the Study of Liver Disease (AASLD) to noninvasively assess advanced liver fibrosis. Modified from [11,45]. CLD: chronic liver disease; ELF: enhanced liver fibrosis; LSM: liver stiffness measurement; MRE: magnetic resonance elastography; T2DM: type 2 diabetes mellitus, TE: transient elastography.
Figure 2
Figure 2
Proposed patient pathway in the general population.
See this image and copyright information in PMC

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