Low MASLD awareness and missed screening opportunities: results from a United Kingdom population and clinician survey

TY - JOUR

T1 - Low MASLD awareness and missed screening opportunities

T2 - results from a United Kingdom population and clinician survey

AU - Leith, Damien

AU - Brennan, Paul N

AU - Lynch, Ruairi W

AU - Byrne, Chris

N1 - © 2026 The Author(s).

PY - 2026/8/26

Y1 - 2026/8/26

N2 - Background and Aims Metabolic dysfunction-associated steatotic liver disease (MASLD) affects over 30% of adults but remains under-recognised. Guidelines recommend screening in high-risk groups, however MASLD awareness among patients and healthcare practitioners (HCP) remains poor, with gaps in knowledge and implementation persisting. We undertook two national surveys to quantify MASLD awareness and knowledge gaps, and explore screening practices among HCPs. Methods This cross-sectional study comprised two online surveys of the general population in Scotland and UK HCPs (primary and secondary care). Surveys assessed recognition of MASLD and associated conditions, factors influencing awareness (including inequalities), and HCP screening practices. Results In the population survey (n=2,114), 71% of respondents were aware of 'fatty liver disease', compared to 5% for MASLD, and 38% for non-alcoholic fatty liver disease (NAFLD) (p<.001). Respondents at higher risk of MASLD, aged less than 60 years, with higher educational attainment, and of female sex, were more likely to be “aware” (all p<0.01). Most (98%) population respondents reacted positively to wanting a MASLD diagnosis if present. Amongst HCPs (n=158), awareness of FLD (100%) and NAFLD (98%) was significantly higher than that of MASLD (57%; p<.001). Only 44% of HCPs reported screening any patients for MASLD. Barriers cited included a lack of familiarity with guidelines, limited access to recommended screening tools, and unclear specialist referral pathways. Conclusions Improved awareness and guideline adoption are imperative to facilitate earlier MASLD diagnosis and intervention. Our findings suggest targeted education for awareness and equitable public health strategies are still needed to address knowledge and management gaps in the UK among both the general population and HCPs.

AB - Background and Aims Metabolic dysfunction-associated steatotic liver disease (MASLD) affects over 30% of adults but remains under-recognised. Guidelines recommend screening in high-risk groups, however MASLD awareness among patients and healthcare practitioners (HCP) remains poor, with gaps in knowledge and implementation persisting. We undertook two national surveys to quantify MASLD awareness and knowledge gaps, and explore screening practices among HCPs. Methods This cross-sectional study comprised two online surveys of the general population in Scotland and UK HCPs (primary and secondary care). Surveys assessed recognition of MASLD and associated conditions, factors influencing awareness (including inequalities), and HCP screening practices. Results In the population survey (n=2,114), 71% of respondents were aware of 'fatty liver disease', compared to 5% for MASLD, and 38% for non-alcoholic fatty liver disease (NAFLD) (p<.001). Respondents at higher risk of MASLD, aged less than 60 years, with higher educational attainment, and of female sex, were more likely to be “aware” (all p<0.01). Most (98%) population respondents reacted positively to wanting a MASLD diagnosis if present. Amongst HCPs (n=158), awareness of FLD (100%) and NAFLD (98%) was significantly higher than that of MASLD (57%; p<.001). Only 44% of HCPs reported screening any patients for MASLD. Barriers cited included a lack of familiarity with guidelines, limited access to recommended screening tools, and unclear specialist referral pathways. Conclusions Improved awareness and guideline adoption are imperative to facilitate earlier MASLD diagnosis and intervention. Our findings suggest targeted education for awareness and equitable public health strategies are still needed to address knowledge and management gaps in the UK among both the general population and HCPs.

KW - Non-alcoholic fatty liver disease

KW - metabolic disease awareness

KW - Scotland

KW - at-risk persons

KW - Screening

KW - Socioeconomic

U2 - 10.1016/j.cgh.2026.07.028

DO - 10.1016/j.cgh.2026.07.028

M3 - Article

C2 - 42648517

SN - 1542-3565

JO - Clinical Gastroenterology and Hepatology

JF - Clinical Gastroenterology and Hepatology

ER -