Cirrhosis of the liver is more common than previously thought, affecting more than 633,000 adults yearly in the US, according to a new study.
And surprisingly, 69 per cent of the adults identified as possibly having cirrhosis may not know they have this disease, researchers said.
“Although some of these individuals may simply have forgotten or been confused about the question, this raises the possibility of a large number of undiagnosed cases of cirrhosis,” said first author Steven Scaglione and colleagues at the Loyola University Chicago Stritch School of Medicine.
Alcohol abuse, diabetes and hepatitis C were the most significant contributing factors in more than 50 per cent of the cirrhosis cases. All three of these factors are potentially preventable, Scaglione said.
Cirrhosis is end-stage scarring of the liver. Symptoms include jaundice, fatigue, bleeding or bruising easily, nausea, swelling and confusion. But many patients have no symptoms.
Cirrhosis can lead to liver failure and liver cancer. In the US, cirrhosis is the 12th leading cause of death overall and the fifth leading cause of death for patients aged 45 to 54.
Scaglione and colleagues performed the first ever study to estimate the prevalence of cirrhosis in the general population.
They examined data from the National Health and Nutrition Examination Survey (NHANES), an annual survey of a representative sample of US adults conducted by the Centres for Disease Control and Prevention.
The prevalence of cirrhosis was approximately 0.27 per cent, which corresponds to 633,323 adults in the US. Previous best-guess estimates pegged the number of adults with cirrhosis at about 400,000.
People with cirrhosis had a mortality rate of 26.4 per cent during a two-year interval, compared with a 8.4 per cent two-year mortality rate among similarly matched adults who did not have cirrhosis.
Compared with the general population, people with cirrhosis tended to be older. Men were more at risk for cirrhosis than women. Prevalence was higher among poor people and people without a domestic partner. Prevalence declined with increasing levels of education.
A quarter of people with cirrhosis reported they drank alcohol in excess during the prior year, and nearly half tested positive for the hepatitis C virus.
The study was published in the Journal of Clinical Gastroenterology.