Many patients with potentially deadly liver cirrhosis and liver cancer are being diagnosed at late advanced stages of the disease, relating to a study led by the Queen Mary University of London in addition to the University of Glasgow.

The study of 18 million people across Europe also suggests the folks coping with type 2 diabetes are in particular risk of this ‘silent disease’ and should be monitored closely to stop life-threatening disease progression.

Non-alcoholic fatty liver disease (NAFLD) affects as much as a quarter of people when you look at the West and is the most common cause of liver disease around the globe. It is closely associated with obesity and type 2 diabetes as well as its rise mirrors the social problems of poor diets and sedentary lifestyles. GPs tend to be unaware of the situation, and patients often go undiagnosed.

In the most common, NAFLD is a benign condition, but one in six people will carry on to build up the aggressive form of the disease, called non-alcoholic steatohepatitis (NASH), leading to liver injury, scarring and in the end in particular to cirrhosis, liver failure and also liver cancer. By identifying which patients might carry on to develop more aggressive disease, interventions, and treatments might be targeted to those at greatest need.

In the most extensive study of its kind, published in the journal BMC Medicine, the team combined the health care records of 18 million European adults through the UK, Netherlands, Italy, and Spain. They matched each NAFLD patient to 100 patients who did not have a recorded diagnosis and looked to see who developed liver cirrhosis and liver cancer in the long run.