Every day in Europe, nearly 780 people die from cirrhosis or liver cancer — conditions that are largely preventable. A major new report from the EASL–Lancet Commission on Liver Health in Europe, co-authored by Professor Harry Rutter, Co-director of Bath’s Centre for 21st Century Public Health, warns that liver disease is an escalating public health crisis across the WHO European Region.
Professor Harry Rutter says: “This stark Lancet report reveals a growing liver disease crisis across Europe, with 780 deaths every day – a clear call to elevate liver disease as a top public health priority.
“It is essential to address the harmful influence of the alcohol and unhealthy food industries on individuals and on policy. The targeting of children and young people by these industries, especially through social media, is particularly egregious.
“The time for action is now. Policy responses must shift away from largely ineffective, individual-focused measures and toward interventions that address the structural drivers of unhealthy behaviour. This means implementing strong, enforceable regulation of unhealthy products and the ways they are marketed.”
The Commission's second report, From Evidence to Impact: Implementing Sustainable Liver Health in Europe, finds that cirrhosis and liver cancer together account for approximately 284,000 deaths annually in Europe. Liver cancer mortality has increased by more than 50% since 2000 — from around 43,000 deaths to approximately 69,000 in 2023. Crucially, liver disease remains one of the few major non-communicable diseases still growing, even as Europe has made progress against conditions like heart disease and cancer.
The economic toll is equally stark. In the absence of liver disease, the combined economies of EU countries and associated European states would be larger by approximately €55 billion annually, with liver disease reducing GDP by around 0.3% across the region — a direct reflection of lost productivity, premature death, and workforce absence.
A preventable crisis with deep root causes
The report highlights how liver disease reflects broader failures in tackling the major drivers of noncommunicable diseases. Alcohol consumption and obesity, alongside viral hepatitis, remain the principal causes of liver-related mortality in Europe. The prevalence of metabolic dysfunction–associated steatotic liver disease (MASLD) continues to rise, driven by obesity, unhealthy diets, and alcohol use.
These risks are strongly shaped by commercial determinants of health — the marketing, pricing, and availability of alcohol and unhealthy foods — highlighting the need for stronger industry regulation and policies that create healthier environments. Eliminating behavioural risk factors alone could almost halve the burden of liver disease, while also reducing cardiovascular disease, diabetes, and cancer.
Prof. Tom H. Karlsen, Commission Co‑Chair, says: “Europe has the knowledge and tools to prevent much of the liver disease burden. The real challenge now is implementation and harmonisation across Europe. There is a window of opportunity to align European health policies against the negative trends we describe in the Commission report.”
A call for coordinated policy action
The Commission calls on European governments, the European Union, and the World Health Organization to place liver health firmly within the region's NCD agenda. Key recommendations include:
- Introducing health warning labels on alcohol products and restricting digital marketing, particularly to young people
- Acting on commercial determinants of health through stronger regulation of alcohol and ultra-processed food marketing and taxation
- Expanding viral hepatitis testing and care for migrants and underserved populations
- Strengthening integrated care models across primary care, specialist services, and community settings
- Integrating liver health into national and global NCD strategies, recognising steatotic liver disease as a preventable NCD
- Improving access to affordable medicines through joint procurement and pricing cooperation among EU Member States
- Integrating liver health metrics into existing NCD monitoring frameworks to ensure accountability
- Acting on commercial determinants of health through stronger regulation of alcohol and ultra-processed food marketing and taxation
Prevention policies — including taxation of harmful products, improved screening and early detection, and better access to treatment — would deliver significant economic returns, according to the Commission's modelling.
A critical opportunity for Europe
Despite strong health systems and a track record of effective public health action — such as tobacco control — liver disease remains one of the few major noncommunicable diseases still increasing.
The Commission identifies three priorities for meaningful progress:
- Make liver disease a top health priority, and include it in national and European health plans
- Detect and treat liver disease earlier, with joined-up care for people who often have multiple health conditions
- Tackle the root causes, including alcohol, unhealthy food, and other factors shaped by industry and the wider environment
The full Commission report is available at The Lancet