P98 A regional evaluation of early cirrhosis detection programmes using unselected staff testing events

<h3>Introduction</h3> The North-east of England has one of the highest rates of hepatocellular carcinoma (HCC) per population in the country, reflecting high rates of alcohol use and the prevalence of metabolic syndrome. Only 25% of patients with HCC are detected by surveillance. An NHS England pilot to detect cirrhosis using Vibration-controlled transient elastography (VCTE) on risk stratified patients in the community is underway. This study explored the prevalence of chronic liver disease in an unselected cohort of participants from staff testing events in the North-East of England. <h3>Methodology</h3> Three large organisations based in the North-east participated in staff testing events between June 2023 and March 2024. Participants were unselected, attending on an ad-hoc basis. All participants completed a pre-scan questionnaire assessing risk factors for liver fibrosis. Harmful alcohol consumption was defined as any of the following: 10-year history of drinking &gt;35units per week; AUDIT-C score ≥8; AUDIT score ≥15. VCTE was performed using Echosens Fibroscan technology. Fibrosis cut-off scores used were: &lt;8 kilopascal (kPa) normal/mild fibrosis; 8–10kPa moderate fibrosis; 10–15kPa advanced fibrosis; 15–25kPa cirrhosis; &gt;25kPa considered high risk of portal hypertension (PHTN). Scans with an interquartile range &gt; 30% were considered invalid. <h3>Results</h3> A total of 597 valid VCTE scans were performed, 389 (65%) participants reported at least one risk factor. Harmful alcohol consumption was reported in 307 (51%) of participants; 135 (23%) participants had a BMI ≥30, while 28 (4.7%) reported type 2 diabetes mellitus (T2DM). Participants with no risk factors all had a Fibroscan &lt;8kPa. Full data was available for those participants with at least one risk factor, of these 234 (59%) were male, with a median age of 44 years (male) and 46 years (female). A total of 3 (0.77%) participants’ results were suggestive of advanced fibrosis, while 1 (0.25%) was suggestive of cirrhosis with risk of PHTN. See table 1. <h3>Conclusion</h3> The prevalence of chronic liver disease in unselected staff testing events is low, despite a high prevalence of risk factors for steatotic liver disease. This is below the current detection rate of cirrhosis for the NHS England pilot in the North-East of England (8%, unpublished data) and would suggest the focus should remain on GP practices and addiction services. The prevalence of excessive alcohol use was greater than that expected in the general population and should be a focus for local public health initiatives given the increased risk of detrimental liver and non-liver related events.