NICE to tackle the rise in cirrhosis
NICE will develop new guidelines on the assessment and management of cirrhosis, as excessive alcohol consumption fuels a rise in the number of cases of the disease.
Every year, around 1,000 people in the UK die from cirrhosis. Around 700 people need to have a liver transplant to survive.
Traditionally, cirrhosis was seen as a disease of patients in their fifties or sixties, but doctors are now seeing rising numbers of patients in their late teens and early 20s with signs of liver scarring.
There has been an almost one thousand per cent increase in liver cirrhosis deaths in the 25 - 44 age group.
Alcohol misuse is one the most common causes of cirrhosis in the UK alongside becoming infected with the hepatitis C virus.
Less common causes include hepatitis B infection, inherited liver diseases, such as haemochromatosis, and a condition called non-alcoholic steatohepatitis (NASH).
Eric Appleby, Chief Executive of Alcohol Concern, said: “Deaths from liver disease have increased by a quarter in less than a decade, and it is now the fifth biggest cause of death in England and Wales.
“A large proportion of these deaths are alcohol-related, and the age of onset is going down: in just seven years the incidence of alcohol-related liver hospital admissions in 25-29 year-olds has gone up by 60 per cent for men and an astonishing 88 per cent for women.
“With this growing need for tackling what is often a hidden illness, there is an urgent need for clear guidelines to support the early identification of cirrhosis and the best possible treatment for sufferers.
“It's often more deprived areas that have the highest incidence of death from liver disease, and it's vital that commissioners and service providers are aware of the local prevalence so that quality provision for treatment and care can be made.
“To do this effectively, we need to continue to develop ways of identifying alcohol misuse as early as possible and provide better techniques for identification of cirrhosis such as ultrasound scanning.”
NICE will develop cirrhosis guidelines as part of the latest topic referral from the Department of Health, which consists of 36 new clinical guidelines.
Other topics that NICE will develop clinical guidelines on include: abdominal aortic aneurysm, menopause, cystic fibrosis, head and neck cancers, macular degeneration, cataracts, and acne.
NICE will also develop guidelines on a number of service delivery topics, including service delivery of out of hours care, consultant review within 12 hours of admission, and managing the transition from children's to adult services.
The latest referrals represent the first tranche of clinical guidelines that are required to develop the underpinning evidence base for NICE Quality Standard topics included in the core library.
All topics put forward to NICE are selected by the Department of Health on the basis of a number of factors, including the burden of disease, the impact on resources, and whether there is inappropriate variation in practice across the country.
The full list of topics referred to NICE:
- Abdominal aortic aneurysm
- Cholelithiasis & cholecystitis
- Liver disease (non-alcoholic)
- Thyroid disease
- Adrenal dysfunction
- Failure to thrive
- Cystic fibrosis
- Cerebral palsy
- Developmental follow-up of pre-term babies
- Parenteral nutrition in neonates
- Renal replacement therapy services
- Renal stones
- Haematological malignancies
- Head and neck cancers
- Skin cancer (including melanoma)
- Seronegative arthropathies
- Macular degeneration
- Long-term conditions, people with comorbidities, complex needs
- Pain management (young people and adults)
- Managing symptoms with an uncertain cause
- Mental health problems with learning disability
- Intravenous fluids in children
- Provision of termination of pregnancy services
- Managing the transition from children's to adult services
- Consultant review within 12 hours of admission
- Out of hours care
- Seven day working
4 July 2012