RT Journal Article
SR Electronic
T1 Burden of nonalcoholic fatty liver disease in Canada, 2019–2030: a modelling study
JF CMAJ Open
JO CMAJ
FD Canadian Medical Association
SP E429
OP E436
DO 10.9778/cmajo.20190212
VO 8
IS 2
A1 Swain, Mark G.
A1 Ramji, Alnoor
A1 Patel, Keyur
A1 Sebastiani, Giada
A1 Shaheen, Abdel Aziz
A1 Tam, Edward
A1 Marotta, Paul
A1 Elkhashab, Magdy
A1 Bajaj, Harpreet S.
A1 Estes, Chris
A1 Razavi, Homie
YR 2020
UL http://www.cmajopen.ca/content/8/2/E429.abstract
AB Background: Nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) account for a growing proportion of liver disease cases, and there is a need to better understand future disease burden. We used a modelling framework to forecast the burden of disease of NAFLD and NASH for Canada.Methods: We used a Markov model to forecast fibrosis progression from stage F0 (no fibrosis) to stage F4 (compensated cirrhosis) and subsequent progression to decompensated cirrhosis, hepatocellular carcinoma, liver transplantation and liver-related death among Canadians with NAFLD from 2019 to 2030. We used historical trends for obesity prevalence among adults to estimate longitudinal changes in the number of incident NAFLD cases.Results: The model projected that the number of NAFLD cases would increase by 20% between 2019 and 2030, from an estimated 7 757 000 cases to 9 305 000 cases. Increases in advanced fibrosis cases were relatively greater, as the number of model-estimated prevalent stage F3 cases would increase by 65%, to 357 000, and that of prevalent stage F4 cases would increase by 95%, to 195 000. Estimated incident cases of hepatocellular carcinoma and decompensated cirrhosis would increase by up to 95%, and the number of annual NAFLD-related deaths would double, to 5600.Interpretation: Increasing rates of obesity translate into increasing NAFLD-related cases of cirrhosis and hepatocellular carcinoma and related mortality. Prevention efforts should be aimed at reducing the incidence of NAFLD and slowing fibrosis progression among those already affected.