Unmet needs around CLD screening & diagnosis

Along the continuum of CLD, poor prognosis can be in part attributed to failures in the screening process

Failures in the screening process result in a high proportion of patients being diagnosed at advanced stages, underuse of curative therapies and delays in treatment delivery in clinical practice1

80% of chronic HCV infections remain undiagnosed worldwide,2 and even among those who undergo HCV screening, there are suboptimal rates of confirmatory HCV RNA testing and linkage to care3


~5% of the global population has significant undetected liver fibrosis or established cirrhosis 4


Cost-effectiveness of screening5 and detection of advanced fibrosis or cirrhosis are improved when non-invasive screening is introduced in routine clinical practice,6 leading to reduction in unnecessary referrals from primary to secondary care by 90%7


The lack of symptoms and the heterogeneity of etiologies make screening and diagnosis of CLD challenging

Globally, CLD is increasing and the heterogeneity and complexity of its etiologies is shifting,4,8,9 posing new challenges in the identification of patients at risk who remain asymptomatic, especially in early stages7

Globally, 1.5 billion people had CLD in 2017, most commonly due to:10




NAFLD is becoming an increasingly important cause of CLD worldwide concurrent with a rising burden of obesity and metabolic syndrome, rapidly shifting the relative contribution of viral hepatitis, NAFLD and ALD to the global burden of CLD8,11 

  • Obesity: 2 billion adults 

  • Diabetes: 400 million people 

Based on the current estimates from 2015 to 2030, prevalence of NAFLD-related decompensated cirrhosis, HCC and deaths will increase by 168%, 137% and 178%, respectively12

The global burden of CLD is underestimated and neglected, and is often associated with significant social stigma

The lack of prospective, national registries and reliable data on the global burden of CLD contributes to the underestimation of the real problem8 and a general neglect of liver health knowledge globally13,14


The paucity of data translates into mortality rates that are likely to be conservative; therefore leading to an underestimation of the real burden of the disease15-17


In addition, liver health receives less attention than many other health areas and there is a need to improve public and political awareness and to ameliorate the associated stigma13,14


Think that liver health is stigmatised


Think that cirrhosis is only caused by alcohol



  1.      Singal AG, et al. Clin Gastroenterol Hepatol 2022;20:9–18.
  2.      Cooke GS, et al. Lancet Gastroenterol Hepatol 2019;4:135–184.
  3.      Yehia BR, et al. PLoS One 2014;9:e101554.
  4.     European Association for the Study of the Liver. J Hepatol 2018;69:182–236.
  5.     Serra-Burriel M, et al. J Hepatol 2019;71:1141–5.
  6.     Thiele M, et al. Gastroenterology 2018;154:1369–79.
  7.     Ginès P, et al. Hepatology 2022;75:219–228.
  8.      Moon AM, et al. Clin Gastroenterol Hepatol 2020;18:2650–2666.
  9.      Moon AM, et al. Alimentary pharmacology & therapeutics 2017;45:1201–1212.
  10.    Disease GBD. Lancet 2018;392:1789–1858.
  11.   Sepanlou SG, et al. Lancet Gastroenterol Hepatol 2020;5:245–66.
  12.   Estes C, et al. Hepatology 2018;67:123–133.
  13.   Wahlin S. and Andersson J. Clin Res Hepatol Gastroenterol 2021;45:101750.
  14.  Marcellin P. and Kutala BK. Liver Int 2018;38(Suppl 1):2-6.
  15.   Mokdad AA, et al. BMC Med 2014;12:145.
  16.  Tapper EB, et al. BMJ 2018;362:k2817.
  17.  Asrani SK, et al. Gastroenterology 2013;145:375–82 e1-2.

Welcome to Medically

The Roche Science Hub

This website is a non-promotional global resource intended to facilitate transparent scientific exchange regarding developments in medical research, diagnostics, and disease management. It is intended for healthcare professionals.

Not a healthcare professional? Browse:

This global website is intended for healthcare professionals outside the UK, US, Canada and Australia. The content on this website may include scientific information about experimental or investigational compounds, indications and services that are not approved or valid in your jurisdiction. Registration status and prescribing information of medicinal products may differ between countries. Please refer to local product information for any medicinal products mentioned on this website. Information available on this website does not constitute professional medical advice, and Roche and Genentech accept no responsibility for access to or use of the same.

You are Leaving Medically

By following this link, you are leaving Roche Website and entering a site that is not owned or controlled by Roche. Roche does not take any responsibility for acces to or use of this website, nor for any content therein.