Dietrich CG, Rau M, Geier A. Screening for nonalcoholic fatty liver disease-when, who and how? World J Gastroenterol 2021; 27(35): 5803-5821 [PMID: 34629804 DOI: 10.3748/wjg.v27.i35.5803]
Corresponding Author of This Article
Christoph G Dietrich, MD, PhD, Chief Doctor, Department of Internal Medicine, Bethlehem Health Center, Steinfeldstr. 5, Stolberg 52222, Germany. christoph.g.dietrich@googlemail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Opinion Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
Share the Article
Dietrich CG, Rau M, Geier A. Screening for nonalcoholic fatty liver disease-when, who and how? World J Gastroenterol 2021; 27(35): 5803-5821 [PMID: 34629804 DOI: 10.3748/wjg.v27.i35.5803]
World J Gastroenterol. Sep 21, 2021; 27(35): 5803-5821 Published online Sep 21, 2021. doi: 10.3748/wjg.v27.i35.5803
Screening for nonalcoholic fatty liver disease-when, who and how?
Christoph G Dietrich, Monika Rau, Andreas Geier
Christoph G Dietrich, Department of Internal Medicine, Bethlehem Health Center, Stolberg 52222, Germany
Monika Rau, Department of Internal Medicine II, University Hospital Würzburg, Würzburg 97080, Germany
Andreas Geier, Department of Medicine II, University Hospital Würzburg, Würzburg 97080, Germany
Author contributions: Dietrich CG and Geier A developed the concept of this review; all authors contributed to the manuscript.
Conflict-of-interest statement: CGD reports personal speaker fees from Falk Foundation. MR declares no conflict of interest. AG serves as advisor and steering committee member for AbbVie, Alexion, Bayer, BMS, CSL Behring, Eisai, Gilead, Intercept, Ipsen, Merz, MSD, Novartis, Pfizer, Roche, Sanofi-Aventis, Sequana and as speaker for AbbVie, Alexion, BMS, CSL Behring, Falk, Gilead, Intercept, Merz, MSD, Novartis, Roche, Sequana. AG also received research support from Intercept and Falk (NAFLD CSG), Novartis.
Corresponding author: Christoph G Dietrich, MD, PhD, Chief Doctor, Department of Internal Medicine, Bethlehem Health Center, Steinfeldstr. 5, Stolberg 52222, Germany. christoph.g.dietrich@googlemail.com
Received: March 16, 2021 Peer-review started: March 16, 2021 First decision: May 1, 2021 Revised: May 13, 2021 Accepted: August 30, 2021 Article in press: August 30, 2021 Published online: September 21, 2021 Processing time: 182 Days and 16.2 Hours
Abstract
Nonalcoholic fatty liver disease (NAFLD) is becoming a frequent liver disease, especially in patients with metabolic syndrome and especially in Western countries. Complications of NAFLD comprise progressive fibrosis, cirrhosis and hepatocellular carcinoma. NAFLD also represents an independent risk factor for cardiovascular disease, extrahepatic neoplasia and other organ damage, such as renal insufficiency. Given the epidemiological importance of the disease, new developments in specific treatment of the disease and the wide availability of noninvasive techniques in estimating steatosis and fibrosis, NAFLD should be subject to screening programs, at least in countries with a high prevalence of the disease. The review discusses prerequisites for screening, cost-effectiveness, current guideline recommendations, suitability of techniques for screening and propositions for the following questions: Who should be screened? Who should perform screening? How should screening be performed? It is time for a screening program in patients at risk for NAFLD.
Core Tip: Nonalcoholic fatty liver disease (NAFLD) is becoming more important in Western countries and leads to serious complications in patients with progressive disease. The epidemiological, clinical and technical requirements for screening for this disease are fulfilled and are outlaid in this review. It is time to consider a screening program for NAFLD.
