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The first-ever Canadian study to forecast the growing burden of Nonalcoholic Fatty Liver Disease (NAFLD or "fatty liver disease") and its more severe form, Nonalcoholic Steatohepatitis (NASH), affirms that the liver conditions are an escalating public health issue, with NASH cases increasing by 35 per cent and deaths expected to double to 49,100 (from 24,400 in 2019) in Canada over the next decade. 

According to "Burden of nonalcoholic fatty liver disease in Canada 2019-2030", published in CMAJ Open, 8(2) (June, 2020), the incidence of serious liver-related consequences as a result of NASH are expected to increase substantially.  Cases of end-stage liver disease (liver failure), liver cancer or liver transplantation, are expected to increase by 65 per cent by 2030 (to 578,000 cases from 349,000 cases in 2019).  In the next decade, NASH-related liver deaths are expected to account for 11.3 per cent of total deaths in Canada (up from 10.9 per cent in 2019).

"In the next 10 years, we expect the economic burden to treat NASH will be driven by patients progressing from fibrosis to the more serious condition of cirrhosis," says Dr. Giada Sebastiani, Associate Professor and Clinician Scientist, Division of Gastroenterology and Hepatology, McGill University Health Centre (Montreal), study author and member of the CanNASH Steering Committee.  "We estimate the number of people with decompensated cirrhosis will double by 2030 and cases of liver cancer will increase by 80 per cent.  As a result, NASH-cirrhosis is estimated to soon become the number one indication for liver transplantation."

NASH is a chronic, progressive liver disease that occurs when excessive amounts of fat build up in the liver, resulting in fibrosis or scarring of the liver.  It is a serious condition that can progress to cirrhosis and potentially result in the need for liver transplantation or death.  Among the five per cent of Canadians with NASH, approximately 17 per cent are predicted to have advanced disease. 

NASH is a chronic, progressive liver disease that occurs when excessive amounts of fat build up in the liver, resulting in fibrosis or scarring of the liver.  It is a serious condition that can progress to cirrhosis and potentially result in the need for liver transplantation or death.  Among the five per cent of Canadians with NASH, approximately 17 per cent are predicted to have advanced disease. 

While NAFLD is often unrecognized and underdiagnosed due to a lack of symptoms, people with risk factors like obesity and diabetes, will be more prone to developing NASH.  Persons with obesity and diabetes should be evaluated for fatty liver disease.

"Unfortunately, the combination of obesity and diabetes within an aging population has created a 'perfect storm' for the progression of fatty liver disease," observes Jennifer Nebesky, President and CEO of the Canadian Liver Foundation (CLF).  "This is compounded by the fact that there is very little awareness about fatty liver among the general Canadian population. The CLF recently commissioned an Ipsos survey that shows that more than 70 per cent of respondents had either never heard of NAFLD or NASH or, at best, knew very little about them.  Without this knowledge, individuals cannot work with their physicians to proactively detect and treat their illness, so the findings of this study—that the disease burden of NAFLD and NASH will increase—are likely more accurate than anyone would like to think."