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I work daily with patients with chronic liver disease, who often develop liver cancer. Unfortunately, liver cancer is often detected late, and few patients can receive curative treatment. In those who can be treated, the tumor often returns, and in the case of widespread disease, the tumor-slowing treatments are often associated with troublesome side effects. The project was started to improve several aspects of the care of patients with liver cancer. By using advanced statistical methods on detailed databases with unique material, we want to contribute to simplifying the early detection of liver cancer and improve the care of those who develop liver cancer. The project has an epidemiological basis, and uses data from several unique data sources to meet our goals. We specifically study the most common form of liver cancer. This is today an increasingly common form of cancer, and one of the deadliest. Part of the project concerns the identification of those with the highest risk of developing cancer. With these, we are studying whether commonly used drugs are associated with a reduced risk. Finally, we investigate whether it is possible to improve the detection of tumor recurrence in patients who have developed cancer, as well as which palliative treatment may be preferable in specific patient groups with disseminated cancer. Liver cancer is a complicated form of tumor that is often detected too late. Here we hope to improve the care of patients with liver cancer on several levels. Our results can hopefully contribute to patients with a high risk of developing cancer being identified and included in specific surveillance programs. In the patients who develop cancer, we want to improve the identification of those with the highest risk of recurrence of the tumor so that specific treatment can be given, and in those with spread cancer, we want to investigate which palliative treatment is best for which patient groups.

Chronic liver disease is a heterogeneous disorder and a common cause of morbidity and mortality. The common thing is that these diseases progress over long periods and then give few or no symptoms, except in the late stages when cirrhosis or hepatocellular carcinoma manifests and prognosis is dismal. Only around 20% of patients with chronic liver disease will develop cirrhosis. Early identification and treatment are associated with an excellent prognosis. Therefore, the issue is to correctly identify pre-cirrhotic disease to initiate treatment and accurately predict which patients will have a benign disease course.Here, we will perform several large, population-based studies to improve diagnostics and prognostication of chronic liver disease in several populations. Using a primary care population of &gt

400.000 persons, we aim to develop statistical models that can accurately predict which persons that have a high risk for future severe liver disease. Additionally, we will evaluate a new screening protocol to detect pre-cirrhotic liver disease in 1000 patients with T2D. A national population-based cohort study will evaluate the prognostic performance of a commonly used ultrasound-based tool used for diagnostics of liver disease. Finally, a population-based cohort consisting of all patients diagnosed with chronic liver disease in Sweden will be constructed and form the foundation for a large number of important observational studies in the field.

Obesity and adult-onset diabetes are becoming more common in the world. In Sweden today, more than half of the population is overweight, and about four percent have adult-onset diabetes. In obesity and diabetes, fat is often stored in the liver, this is called fatty liver. Fatty liver is found today in over 25% of the world's population. In a small proportion of these, liver cancer can occur. Fatty liver globally today causes more cases of liver cancer than alcohol and hepatitis C. There are no good methods to be able to identify those individuals with obesity, diabetes and fatty liver who are at increased risk of developing liver cancer. In this project, we study in a number of unique cohorts people with obesity, diabetes or diagnosed fatty liver in different stages of the disease. Through advanced statistical methods, we try to identify the groups of people who are most at risk of developing liver cancer. The advantage of the project is access to a number of unique cohorts that are large enough to be able to meet the goals of the studies. We have a broad competence in the research group, with access to experts in liver diseases and liver cancer, epidemiology and statistics. This ensures that the studies can be carried out with the highest possible quality. Fatty liver is a potentially major societal problem. As the liver is very resistant to disease, it often takes over 20 years of exposure to fatty liver before liver cancer occurs. The obesity epidemic risks leading to a larger number of individuals in the future will develop liver cancer. However, the individual risk for this is low. We hope to be able to identify relevant risk groups with obesity, adult-onset diabetes and fatty liver where the risk of developing liver cancer is particularly high. We also hope to propose methods to reduce the risk of liver cancer in people in these risk groups.

Obesity and adult-onset diabetes are becoming more common in the world. In Sweden today, more than half of the population is overweight, and about four percent have adult-onset diabetes. In obesity and diabetes, fat is often stored in the liver, this is called fatty liver. Fatty liver is found today in over 25% of the world's population. In a small proportion of these, liver cancer can occur. Fatty liver globally today causes more cases of liver cancer than alcohol and hepatitis C. There are no good methods to be able to identify those individuals with obesity, diabetes and fatty liver who are at increased risk of developing liver cancer. In this project, we study in a number of unique cohorts people with obesity, diabetes or diagnosed fatty liver in different stages of the disease. Through advanced statistical methods, we try to identify the groups of people who are most at risk of developing liver cancer. The advantage of the project is access to a number of unique cohorts that are large enough to be able to meet the goals of the studies. We have a broad competence in the research group, with access to experts in liver diseases and liver cancer, epidemiology and statistics. This ensures that the studies can be carried out with the highest possible quality. Fatty liver is a potentially major societal problem. As the liver is very resistant to disease, it often takes over 20 years of exposure to fatty liver before liver cancer occurs. The obesity epidemic risks leading to a larger number of individuals in the future will develop liver cancer. However, the individual risk for this is low. We hope to be able to identify relevant risk groups with obesity, adult-onset diabetes and fatty liver where the risk of developing liver cancer is particularly high. We also hope to propose methods to reduce the risk of liver cancer in people in these risk groups.