Over 40 Percent of US Adults Are at Risk of Liver Disease by 2050, Study Warns

Liver transplant demand is set to quadruple by 2050 as liver disease cases rise.

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Nearly half of all U.S. adults could suffer from chronic liver disease by 2050, according to new research that projects a massive surge in cases requiring transplants and specialized care.

The study predicts that metabolic dysfunction-associated steatotic liver disease (MASLD) will affect 121.9 million adults—about 41 percent of the U.S. population.

Liver Disease Cases to Surge by 2050

The new study, published in JAMA Network Open on Jan. 17, projected that by 2050, the number of adults suffering from MASLD, formally known as nonalcoholic fatty liver disease, could increase from the 86.3 million who had it in 2020 to approximately 121.9 million. This accounts for 41.4 percent of the adult U.S. population.

MASLD is a condition wherein excess fat builds up in the liver, leading to potential liver damage. It’s the most common cause of chronic liver disease in the United States.

The researchers used a microsimulation model to simulate health outcomes for people within a population over time, analyzing the progression of MASLD among more than 2.8 million individuals.

While this study wasn’t designed to determine why cases of this disorder are on the rise, the disease is strongly linked with obesity and diabetes, two serious health issues that are also on the rise.

The number of people with metabolic dysfunction-associated steatohepatitis (MASH), a more severe form of MASLD, is also expected to rise from nearly 6 percent of U.S. adults in 2020 to almost 8 percent in 2050.

The increasing burden of MASLD is expected to accompany potentially severe health complications.

The researchers estimated that the number of new cases of liver cancer, known as hepatocellular carcinoma (HCC), will almost double from the 2020–2025 period to the 2046–2050 period, and liver transplant cases are expected to quadruple during this time.

The share of liver-related deaths is projected to jump from about 1 percent of all-cause mortality in 2020 to 2.4 percent by 2050, according to the study’s findings.

The research team emphasized a need for urgent planning within health care systems to address these challenges. “These results suggest that health systems should plan for large increases in the number of HCC cases and in the need for [liver transplants],” they wrote.

Older Adults Most Affected

The study highlighted a disparity in disease progression among different age groups. Adults ages 80 years and older are expected to experience the most significant increases in MASLD prevalence.

Additionally, the proportion of patients experiencing more severe fibrosis stages—indicating worse liver damage—is also expected to rise, suggesting a trend toward more advanced cases of the disease.

Despite these projections, the study authors noted that advancements in treatment options could alter this trajectory. New medications such as resmetirom show promise in improving liver health and potentially reducing MASLD progression, according to the authors.

“While our projected increase in MASLD prevalence poses a significant challenge for health care systems, it is not inevitable,” the study authors wrote. “By implementing preventive strategies, investing in research, and preparing health care systems, we can minimize the impact of MASLD.”

Lifestyle changes can minimize the impact of MASLD among those living with the condition. These include weight management, regular physical activity, and a balanced diet, all of which can also help prevent or slow disease progression.