New Lancet Commission calls for urgent action to tackle Europe’s rising liver disease burden

New Lancet Commission calls for urgent action to tackle Europe’s rising liver disease burden

Every day in Europe, nearly 780 people die from cirrhosis or liver cancer — conditions that are largely preventable. A major new report from the EASL–Lancet Commission on Liver Health in Europe warns that liver disease is an escalating public health crisis across the WHO European Region, and calls on governments to implement stronger prevention policies and integrate liver health into broader non-communicable disease (NCD) strategies.

The Commission’s second report, From Evidence to Impact: Implementing Sustainable Liver Health in Europe, finds that cirrhosis and liver cancer together account for approximately 284,000 deaths annually in Europe. Liver cancer mortality has increased by more than 50% since 2000 — from around 43,000 deaths to approximately 69,000 in 2023. Crucially, liver disease remains one of the few major non-communicable diseases still growing, even as Europe has made progress against conditions like heart disease and cancer.

The economic toll is equally stark. In the absence of liver disease, the combined economies of EU countries and associated European states would be larger by approximately €55 billion annually, with liver disease reducing GDP by around 0.3% across the region — a direct reflection of lost productivity, premature death, and workforce absence.

“Current data should be a wake-up call. In the WHO European Region, cirrhosis and liver cancer cause nearly 780 deaths every day — around 3% of all deaths. Tackling the shared risk factors that drive liver disease, including alcohol, unhealthy diets, and viral hepatitis, needs to be an integral part of the broader response to noncommunicable diseases,” said Dr Hans Kluge, WHO Regional Director for Europe.

A preventable crisis with deep root causes

The report highlights how liver disease reflects broader failures in tackling the major drivers of non-communicable diseases. Alcohol consumption and obesity, alongside viral hepatitis, remain the principal causes of liver-related mortality in Europe. The prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) continues to rise, driven by obesity, unhealthy diets, and alcohol use.

These risks are strongly shaped by commercial determinants of health — the marketing, pricing, and availability of alcohol and unhealthy foods — highlighting the need for stronger industry regulation and policies that create healthier environments. Eliminating behavioural risk factors alone could almost halve the burden of liver disease, while also reducing cardiovascular disease, diabetes, and cancer.

“Europe has the knowledge and tools to prevent much of the liver disease burden. The real challenge now is implementation and harmonisation across Europe. There is a window of opportunity to align European health policies against the negative trends we describe in the Commission report,” said Prof. Tom H. Karlsen, Commission Co-Chair.

The patient reality 

Behind the statistics are hundreds of thousands of people across Europe who are still being diagnosed too late — when treatment options are limited and outcomes are poor.

“For patients living with liver disease, this report is long overdue. Too many people across Europe are still being diagnosed too late, when treatment options are limited and outcomes are poor. The Commission’s recommendations — on earlier detection, integrated care, and tackling the root causes of disease — reflect what patients and their families have been asking for. We now urge policymakers to move from words to action, because for the people we represent, time is not a luxury,” said Marko Korenjak, President of the European Liver Patients Association (ELPA).

A call for coordinated policy action 

The Commission calls on European governments, the European Union, and the World Health Organization to place liver health firmly within the region’s NCD agenda. Key recommendations include:

• Introducing health warning labels on alcohol products and restricting digital marketing, particularly to young people
• Acting on commercial determinants of health through stronger regulation of alcohol and ultra-processed food marketing and taxation
• Expanding viral hepatitis testing and care for migrants and underserved populations
• Strengthening integrated care models across primary care, specialist services, and community settings
• Integrating liver health into national and global NCD strategies, recognising steatotic liver disease as a preventable NCD
• Improving access to affordable medicines through joint procurement and pricing cooperation among EU Member States
• Integrating liver health metrics into existing NCD monitoring frameworks to ensure accountability

Prevention policies — including taxation of harmful products, improved screening and early detection, and better access to treatment — would deliver significant economic returns, according to the Commission’s modelling.

A critical opportunity for Europe

Europe stands at a pivotal moment. Despite strong health systems and a track record of effective public health action — such as tobacco control — liver disease remains one of the few major non-communicable diseases still increasing. Without urgent and coordinated action, its health, societal, and economic impacts will continue to escalate.

The Commission identifies three priorities for meaningful progress:

• Make liver disease a top health priority, and include it in national and European health plans
• Detect and treat liver disease earlier, with joined-up care for people who often have multiple health conditions
• Tackle the root causes, including alcohol, unhealthy food, and other factors shaped by industry and the wider environment

“Liver disease is no longer a silent condition — it is a growing public health failure that we have the tools to prevent. What is missing is not evidence, but action. Europe now has a clear opportunity to turn the tide, but this will require political courage to address the root causes of disease and put health ahead of harmful commercial interests,” said Prof. Debbie Shawcross, EASL Secretary General.

About the Commission

The EASL–Lancet Commission on Liver Health in Europe brings together leading experts in hepatology, public health, mental health, economics, patient representatives, and health policy to assess the burden of liver disease and propose evidence-based strategies to improve liver health across the region. The Commission’s first report was published in 2021.

About EASL

The European Association for the Study of the Liver (EASL) is a leading global medical association dedicated to advancing research, education, policy, and clinical care to improve liver health and promote the prevention and treatment of liver diseases worldwide.

For media enquiries, please contact

EASL press contact Irene Mosqueira
irene.mosqueira@easloffice.eu

The full Commission report is available at https://www.thelancet.com/commissions-do/europe-liver-health.