Liver Disease: A Race Against Time
Education and Advocacy Dr. Morris Sherman, Chairman of the Canadian Liver Foundation and a liver specialist at Toronto General Hospital, warns of the perils of liver disease—a silent epidemic with grave consequences.
Liver disease is a global health crisis that has been quietly brewing for decades and is now beginning to boil over. Adults in the prime of their lives are being diagnosed with end-stage liver disease, specialists have long waiting lists and intensive care units are filling up with liver patients—all consequences of a lack of urgency to identify and treat liver disease in its early stages.
Canadians on liver health
Earlier this year, I was the lead author of Liver Disease in Canada: A Crisis in the Making, a report commissioned by the Canadian Liver Foundation that attempted to quantify the burden of liver disease and make recommendations on how to prevent unnecessary deaths from treatable—and in some cases preventable—liver diseases. Our report showed that the true scope of liver disease in Canada, although difficult to measure because of non-existent or inconsistent data, is much greater than previously thought. The death rate from liver disease has increased by 30 percent over an 8-year period. This is a global phenomenon. Similar reports have recently been published in the UK and in Europe. Our report also shows that if we do not invest resources to improve prevention, diagnosis and treatment now, individuals, families and health care systems will pay a heavy price in premature deaths and skyrocketing patient care costs.
"Liver cancer is the end result of many forms of chronic liver disease. This rise in liver cancer rates is a direct result of our failure to identify and treat liver disease at an early stage when there is the greatest possibility of managing—or in some cases even curing—these patients."
Liver disease often has no symptoms but it is detectable. Simple blood tests could alert primary care physicians to potential liver problems. Widespread screening could identify hepatitis B or C—two of the most common and potentially life-threatening liver diseases —before they have time to develop into liver cancer, cirrhosis or liver failure. In the absence of appropriate screening protocols, however, opportunities to intervene are being missed.
Recently, new cancer statistics highlighted liver cancer as one of the fastest rising and deadliest forms of cancer in Canada. Liver cancer is the end result of many forms of chronic liver disease. This rise in liver cancer rates is a direct result of our failure to identify and treat liver disease at an early stage when there is the greatest possibility of managing—or in some cases even curing—these patients.
Our report makes 21 recommendations covering everything from preventative measures like universal neonatal immunization for hepatitis B to less restrictive drug reimbursement policies to allow for greater access to treatment. We are urging federal, provincial and territorial governments to work together to incorporate these recommendations into Canada’s first national liver disease strategy to improve surveillance, screening, patient care, and research.
We cannot wait to act. We are in a race against time and with the lives of Canadians at risk or living with liver disease, this is not a race we can afford to lose.