ArticleCanadian liver journal2025
Barriers and facilitators to liver fibrosis screening: Perspectives and practices of Canadian primary care physicians.
Article in Canadian liver journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- The MASLD Journey in the General Population: Linkage-to-Care and Patient-Reported Uptake of Fibrosis Risk Assessment.Liver international : official journal of the International Association for the Study of the Liver · 2026Article
- Reimbursement restrictions reduce liver fibrosis screening in adults with diabetes in Ontario: a population-based interrupted time series analysis.Scientific reports · 2026Article
- Call to action: integrating steatotic liver disease into public health strategies in Canada.Lancet regional health. Americas · 2025Review
Corrections and comments
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is highly prevalent, yet primary care physicians (PCPs) face barriers to identifying and referring high-risk individuals. We surveyed Canadian PCPs to identify barriers and facilitators to MASLD-related fibrosis screening. Methods: A multidisciplinary team developed a 38-item online survey with multiple-choice and Likert scale questions to assess PCPs' MASLD knowledge and barriers and facilitators to screening. The survey was distributed anonymously in April-August 2024. Results: Seventy-one participants completed the survey. One in five rated their MASLD diagnostic knowledge as very or extremely familiar, whereas a quarter reported little to no knowledge. Although >90% correctly identified obesity, type 2 diabetes, and dyslipidemia as risk factors, only 54% screened these populations. Among those who screened, 55% used FIB-4 and 29% transient elastography, while the most common tools were ultrasound (74%) and alanine aminotransferase (71%). Overall, 96% reported at least one barrier, including time limitations, resource constraints, and limited access to tools. Barriers also varied by province; PCPs in Alberta reported fewer access issues with tools like FIB-4 than those in other provinces, including Ontario and Quebec. Encouragingly, over 80% expressed willingness to adopt integrated guidelines and automated risk tools into their practice. Conclusions: Despite awareness of MASLD risk factors among Canadian PCPs, substantial gaps remain in screening due to limited knowledge, inconsistent tool use, and systemic barriers. These findings highlight the need for a coordinated national strategy to support PCPs in the early identification and referral of patients at risk for MASLD-related fibrosis.
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