ArticleHepatology communications2026
Targeted community screening in areas of high socioeconomic deprivation enhances the detection of liver fibrosis.
Article in Hepatology communications, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundRisk-factor-based community screening has been used to identify early liver disease. Risk-factor prevalence and liver-related outcomes are significantly affected by socioeconomic deprivation. However, the impact on targeted community screening is unknown. We evaluated the influence of deprivation on fibrosis detection within a population screening pathway.
methodsA total of 1613 patients were assessed using 2 pathways: Proactive case finding at 7 primary care practices (PCPs) and a comparator standard-of-care pathway. Individuals with specific risk factors were identified: obesity (BMI >30 kg/m2), type 2 diabetes, alcohol consumption >400/>280 g/week in males/females, respectively, coding for steatosis and ALT >50/>35 IU/mL in males/females, respectively. Liver stiffness measurement (LSM) ≥8.0 kPa was used to determine fibrosis, and the Index of Multiple Deprivation (IMD) was used to determine deprivation at the individual and neighborhood level.
resultsIn all, 325 (20.1%) patients had LSM ≥8.0 kPa. Fibrosis detection increased with the number of risk factors [2: OR 2.47 (p=0.027, 95% CI 1.11-5.50), 3: OR 5.19 (p <0.001, 95% CI 2.34-11.53), 4: OR 10.19 (p <0.001, 95% CI 4.44-23.40), 5: OR 23.40 (p <0.001, 95% CI 6.15-89.04)]. Patients with a low IMD score (<10) had significantly lower median LSMs than those with a high IMD score (>50) [5.4 kPa vs. 6.0 kPa (p=0.0005)]. In the proactive case finding pathway, obesity prevalence was higher in PCPs in areas of high deprivation [83.5% vs. 65.6% (p=0.003)]. Fibrosis detection was significantly higher in PCPs situated in neighborhoods with high socioeconomic deprivation compared with low deprivation [27.0% vs. 8.6% (p=0.028)].
conclusionLiver fibrosis detection was disproportionately higher in neighborhoods with greater socioeconomic deprivation. Screening strategies targeting areas with higher deprivation could increase the diagnostic yield of advanced fibrosis.
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