Screening for liver fibrosis: a population-based study in European countries

LiverScreen develops FibroScan, a non-invasive device to scan for common liver conditions that typically show no symptoms until the disease is very advanced. This EIT Health project tests 3 000 patients with FibroScan, to prove the effectiveness of screening that could save lives and money by catching liver problems before cirrhosis or cancer set in.


It is predicted there will be an explosion of patients with chronic liver disease in the near future due to the current epidemics of obesity and diabetes. Chronic liver disease is usually silent until progression to liver cirrhosis and cancer is inevitable, and the chances for survival are lower. Advanced liver disease is costly for healthcare systems and poses an enormous emotional burden for patients and families. LiverScreen offers a solution for early intervention.


The project involves a multi-disciplinary, international team of doctors, nurses, economists, business planners, statisticians and quality controllers. The healthcare teams are from France, Netherlands, and Spain. The health economists, quality governance team and statisticians are from public institutions in Spain, with ECHOSENS providing the equipment and analysis of screening images. Health economists are building future business models.

The project

The LiverScreen project develops a personalised screening program to identify persons with pre-symptomatic, significant chronic liver disease among the general population. Liverscreen uses FibroScan (pictured, right), a non-invasive medical device, to measure liver stiffness that correlates with the degree of liver fibrosis. FibroScan has high potential to quantify liver fibrosis in persons with early stage and pre-symptomatic liver disease, when available treatments could halt progression or even favor regression of liver fibrosis.

A total of 3 000 subjects from the general population will be included in this project (2 000 in Spain, 500 in France and 500 in Netherlands). Subjects are evaluated by a study nurse in a primary care centre, where medical history, physical examination, blood tests and the FibroScan test are performed. Subjects presumed to have liver fibrosis, because of values detected by FibroScan or abnormal liver tests, are subsequently evaluated in a hepatology consultation at the reference university hospital linked to the primary care centre, to confirm the diagnosis and offer specific treatment.

The LiverScreen project will assess not only the prevalence of liver fibrosis in the general population but also will identify subgroups of patients at risk of chronic liver diseases, to help develop a targeted, population-based screening program for liver disease.


  • For patients: Identification of patients at risk of developing liver disease can mean early and more cost-effective treatment – and therapy to prevent further development.
  • For society: Improved forecasting permits better allocation of resources and healthcare policy to address the problem of liver disease in both primary care and hospital settings.
  • For healthcare professionals: education and training of staff with specialist skill sets needed for the future in the health care systems.

Why this is an EIT Health project

An effort to identify the prevalence of early signs of liver disease within the adult population is in keeping with EIT Health’s goal of improving healthcare for all Europeans. LiverScreen aligns with the Focus Areas of “Care Pathways”, because early detection can improve treatment, and to a certain extent, “Real World Data”, because it will build a database indicating at-risk groups.

Dr Pere Ginès
| Chief of Unit | Fundació Clínic per la Recerca Biomèdica