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. 2025 Mar 18:10.1097/HEP.0000000000001311.
doi: 10.1097/HEP.0000000000001311. Online ahead of print.

Population perspectives on benefits and harms of screening for metabolic dysfunction-associated steatotic liver disease

Alina M Allen  1 , W Ray Kim  2 , Patrizia Carrieri  3 , Rachel Canning  4 , Fang-Shu Ou  4 , Joanne Benson  4 , Jessica L Olson  1 , Sudhakar K Venkatesh  5 , Jiahui Li  5 , Meng Yin  5 , Maysa Eslami  1 , Richard L Ehman  5 , Jennifer Hunter Berg, Jeffrey V Lazarus  6   7   8
Affiliations

Population perspectives on benefits and harms of screening for metabolic dysfunction-associated steatotic liver disease

Alina M Allen et al. Hepatology. .

Abstract

Background and aims: Screening for diseases can have psychological impacts, such as anxiety, and requires acceptability from the population to be effective. This study examined the perspectives on the benefits and harms of screening for metabolic dysfunction-associated steatotic liver disease (MASLD) among the general population to optimize screening practices.

Approach and results: A survey was sent to participants enrolled between 2020 and 2024 in a prospective MASLD screening study in Olmsted County, MN. The survey assessed participants' perceived anxiety, stigma, quality of life, preferred screening methods, financial concerns, and lifestyle impacts following screening and diagnosis. Of the 461 participants, 342 (74%) completed the survey. Overall, 14% of participants reported screening-related anxiety, and 14% were concerned about disclosing a potential MASLD diagnosis to others. Among those without a MASLD diagnosis, 99% felt reassured about their liver health, 48% reported an improved quality of life, and 25% made lifestyle changes pertaining to their diet, alcohol use, and physical activity. Of the 77 participants diagnosed with MASLD, 52% experienced some anxiety about their new diagnosis; however, 95% and 97% considered it important to receive an early MASLD diagnosis to mitigate the risk for cirrhosis and cardiovascular disease, respectively. Notably, 79% of diagnosed participants found the diagnosis beneficial in adopting healthier habits, with 30% achieving a >10% weight loss after screening.

Conclusion: This population-based survey demonstrates that the perceived benefits of proactive MASLD screening, such as increased awareness, lifestyle changes, and early diagnosis, outweigh the harms. These findings highlight the importance of early screening through patient-centered protocols to improve health outcomes.

Keywords: alphabetical style; fatty liver; metabolic dysfunction–associated steatohepatitis; survey.

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Conflict of interest statement

Conflict of interest/disclosures:

Alina Allen consults for and received grants paid to her institution from Novo Nordisk. She consults for GSK, Prosciento, Madrigal, and Boehringer-Ingelheim. She received grants paid to her institution from the National Institutes of Health, Pfizer, Target Pharma, Siemens, Oncoustics, and Escopics.

Sudhakar K. Venkatesh received grants (NIBIB R01EB017197, NIDDK R01DK132718, R01DK136731) from the National Institutes of Health.

Meng Yin received grants (NIBIB R01EB017197, NIDDK R01DK132718, R01DK136731) from the National Institutes of Health. She owns stock in Resoundant, Inc. Ming Yin and Mayo Clinic have intellectual property rights, and a financial interest related to magnetic resonance elastography technology. The research was reviewed by the Mayo Clinic Conflict of Interest Review Board and was conducted in compliance with Mayo Clinic Conflict of Interest policies.

Richard L. Ehman received grants (NIBIB R37 EB001981) from the National Institutes of Health. He received grants from, owns stock in, owns intellectual property rights with, and has other interests with Resoundant, Inc. Richard L. Ehman and Mayo Clinic have intellectual property rights, and a financial interest related to magnetic resonance elastography technology. The research was reviewed by the Mayo Clinic Conflict of Interest Review Board and was conducted in compliance with Mayo Clinic Conflict of Interest policies.

Jennifer Hunter Berg consults for and owns stock in Madrigal. She consults for Regeneron.

Jeffrey V. Lazarus consults for, is on the speakers’ bureau for, and received grants to paid to his institutions from Echosens, Novo Nordisk, and Pfizer. He is on the speakers’ bureau and received grants paid to his institutions from AbbVie, Gilead, Moderna, and MSD. He consults for NovoVax, GSK, and Prosciento. He is on the speakers’ bureau for Janssen. He received grants paid to his institutions from Boehringer Ingelheim, Madrigal, and Roche. He received grants CEX2023–0001290-S, paid to his institution, funded by MCIN/AEI/10.13039/501100011033, and from the Generalitat de Catalunya, through the CERCA Program.

The remaining authors have no conflicts to report.

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