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Gathering momentum for the way ahead: fifth report of the Lancet Standing Commission on Liver Disease in the UK

Gathering momentum for the way ahead: fifth report of the Lancet Standing Commission on Liver Disease in the UK
Gathering momentum for the way ahead: fifth report of the Lancet Standing Commission on Liver Disease in the UK

This report presents further evidence on the escalating alcohol consumption in the UK and the burden of liver disease associated with this major risk factor, as well as the effects on hospital and primary care. We reiterate the need for fiscal regulation by the UK Government if overall alcohol consumption is to be reduced sufficiently to improve health outcomes. We also draw attention to the effects of drastic cuts in public services for alcohol treatment, the repeated failures of voluntary agreements with the drinks industry, and the influence of the industry through its lobbying activities. We continue to press for reintroduction of the alcohol duty escalator, which was highly effective during the 5 years it was in place, and the introduction of minimum unit pricing in England, targeted at the heaviest drinkers. Results from the introduction of minimum unit pricing in Scotland, with results from Wales to follow, are likely to seriously expose the weakness of England's position. The increasing prevalence of obesity-related liver disease, the rising number of people diagnosed with type 2 diabetes and its complications, and increasing number of cases of end-stage liver disease and primary liver cancers from non-alcoholic fatty liver disease make apparent the need for an obesity strategy for adults. We also discuss the important effects of obesity and alcohol on disease progression, and the increased risk of the ten most common cancers (including breast and colon cancers). A new in-depth analysis of the UK National Health Service (NHS) and total societal costs shows the extraordinarily large expenditures that could be saved or redeployed elsewhere in the NHS. Excellent results have been reported for new antiviral drugs for hepatitis C virus infection, making elimination of chronic infection a real possibility ahead of the WHO 2030 target. However, the extent of unidentified cases remains a problem, and will also apply when new curative drugs for hepatitis B virus become available. We also describe efforts to improve standards of hospital care for liver disease with better understanding of current service deficiencies and a new accreditation process for hospitals providing liver services. New commissioning arrangements for primary and community care represent progress, in terms of effective screening of high-risk subjects and the early detection of liver disease.

0140-6736
2398-2412
Williams, Roger
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O'Grady, John
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Rutter, Harry
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Sheron, Nick
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Thorburn, Douglas
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Williams, Roger, Alexander, Graeme, Aspinall, Richard, Batterham, Rachel, Bhala, Neeraj, Bosanquet, Nick, Severi, Katherine, Burton, Anya, Burton, Robyn, Cramp, Matthew E., Day, Natalie, Dhawan, Anil, Dillon, John, Drummond, Colin, Dyson, Jessica, Ferguson, James, Foster, Graham R., Gilmore, Ian, Greenberg, Jonny, Henn, Clive, Hudson, Mark, Jarvis, Helen, Kelly, Deirdre, Mann, Jake, McDougall, Neil, McKee, Martin, Moriarty, Kieran, Morling, Joanne, Newsome, Philip, O'Grady, John, Rolfe, Liz, Rice, Peter, Rutter, Harry, Sheron, Nick, Thorburn, Douglas, Verne, Julia, Vohra, Jyotsna, Wass, John and Yeoman, Andrew (2018) Gathering momentum for the way ahead: fifth report of the Lancet Standing Commission on Liver Disease in the UK. The Lancet, 392 (10162), 2398-2412. (doi:10.1016/S0140-6736(18)32561-3).

Record type: Letter

Abstract

This report presents further evidence on the escalating alcohol consumption in the UK and the burden of liver disease associated with this major risk factor, as well as the effects on hospital and primary care. We reiterate the need for fiscal regulation by the UK Government if overall alcohol consumption is to be reduced sufficiently to improve health outcomes. We also draw attention to the effects of drastic cuts in public services for alcohol treatment, the repeated failures of voluntary agreements with the drinks industry, and the influence of the industry through its lobbying activities. We continue to press for reintroduction of the alcohol duty escalator, which was highly effective during the 5 years it was in place, and the introduction of minimum unit pricing in England, targeted at the heaviest drinkers. Results from the introduction of minimum unit pricing in Scotland, with results from Wales to follow, are likely to seriously expose the weakness of England's position. The increasing prevalence of obesity-related liver disease, the rising number of people diagnosed with type 2 diabetes and its complications, and increasing number of cases of end-stage liver disease and primary liver cancers from non-alcoholic fatty liver disease make apparent the need for an obesity strategy for adults. We also discuss the important effects of obesity and alcohol on disease progression, and the increased risk of the ten most common cancers (including breast and colon cancers). A new in-depth analysis of the UK National Health Service (NHS) and total societal costs shows the extraordinarily large expenditures that could be saved or redeployed elsewhere in the NHS. Excellent results have been reported for new antiviral drugs for hepatitis C virus infection, making elimination of chronic infection a real possibility ahead of the WHO 2030 target. However, the extent of unidentified cases remains a problem, and will also apply when new curative drugs for hepatitis B virus become available. We also describe efforts to improve standards of hospital care for liver disease with better understanding of current service deficiencies and a new accreditation process for hospitals providing liver services. New commissioning arrangements for primary and community care represent progress, in terms of effective screening of high-risk subjects and the early detection of liver disease.

Full text not available from this repository.

More information

e-pub ahead of print date: 22 November 2018
Published date: 1 December 2018

Identifiers

Local EPrints ID: 428419
URI: http://eprints.soton.ac.uk/id/eprint/428419
ISSN: 0140-6736
PURE UUID: 293a643e-2cb5-4d2f-8058-f3cd97ea8e51
ORCID for Nick Sheron: ORCID iD orcid.org/0000-0001-5232-8292

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Date deposited: 22 Feb 2019 17:31
Last modified: 07 Oct 2020 00:58

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Contributors

Author: Roger Williams
Author: Graeme Alexander
Author: Richard Aspinall
Author: Rachel Batterham
Author: Neeraj Bhala
Author: Nick Bosanquet
Author: Katherine Severi
Author: Anya Burton
Author: Robyn Burton
Author: Matthew E. Cramp
Author: Natalie Day
Author: Anil Dhawan
Author: John Dillon
Author: Colin Drummond
Author: Jessica Dyson
Author: James Ferguson
Author: Graham R. Foster
Author: Ian Gilmore
Author: Jonny Greenberg
Author: Clive Henn
Author: Mark Hudson
Author: Helen Jarvis
Author: Deirdre Kelly
Author: Jake Mann
Author: Neil McDougall
Author: Martin McKee
Author: Kieran Moriarty
Author: Joanne Morling
Author: Philip Newsome
Author: John O'Grady
Author: Liz Rolfe
Author: Peter Rice
Author: Harry Rutter
Author: Nick Sheron ORCID iD
Author: Douglas Thorburn
Author: Julia Verne
Author: Jyotsna Vohra
Author: John Wass
Author: Andrew Yeoman

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