Liver Disease in Singapore

Area of Science:

• Hepatology and Gastroenterology
• Public Health
• Epidemiology

Background:

• Liver disease poses a significant health burden in Singapore, contributing substantially to years of life lost (YLL).
• Liver cancer is the 5th most common cancer in males, while liver cirrhosis is a major concern, with chronic hepatitis B (CHB) as the primary cause.
• The prevalence of liver cancer and CHB is declining, but alcoholic liver disease and fatty liver disease prevalence are less understood and potentially increasing.

Purpose of the Study:

• To analyze the burden of liver disease in Singapore, including liver cancer and cirrhosis.
• To identify the primary etiologies and prevalence rates of liver cirrhosis.
• To discuss current healthcare provisions and the need for a national action plan for liver disease management.

Main Methods:

• Analysis of data from the Singapore Burden of Disease Survey.
• Review of seroprevalence rates for chronic hepatitis B (CHB) and chronic hepatitis C (CHC).
• Examination of trends in liver cancer and CHB prevalence.
• Assessment of Singapore's healthcare system and existing support schemes for liver disease treatment.

Main Results:

• Liver cancer and liver cirrhosis accounted for 3.2% and 0.9% of YLL, respectively.
• Chronic hepatitis B (CHB) is the leading cause of liver cirrhosis (63.3%), followed by alcohol (11.2%).
• The seroprevalence of CHB is 3.6%, and CHC is approximately 0.1%.
• Trends show a gradual reduction in liver cancer and CHB, with a potential increase in fatty liver disease.

Conclusions:

• Liver disease remains a critical public health issue in Singapore, necessitating ongoing monitoring and intervention.
• While CHB prevalence is decreasing, the rising concern of fatty liver disease requires further investigation and targeted strategies.
• A comprehensive national action plan involving healthcare specialists, government, and non-government agencies is crucial for effectively tackling liver disease.