TOPLINE

The prevalence of fibrosis has increased substantially in England over a decade. Patients with multiple organ fibrosis had a markedly higher risk for mortality than those with single organ fibrosis.

METHODOLOGY

• Researchers conducted a retrospective, population-based cohort study using linked primary and secondary care data from the Clinical Practice Research Datalink to assess the prevalence of fibrosis from 2012 to 2022.
• The analysis included about 18.78 million adults, of whom nearly 5.84 million had at least one fibrotic condition.
• Fibrotic conditions were defined through a Delphi survey; grouped on the basis of organ or disease groups, including lung fibrosis, liver fibrosis, cardiomyopathy, insulin-resistant type 2 diabetes, treatment-resistant hypertension, and systemic fibrosis; and identified using clinical codes.
• Multiple organ fibrosis was defined as a later diagnosis of a fibrotic condition affecting a different organ system.
• Secondary outcomes were the count of fibrotic conditions and mortality; the risk for mortality according to the number of fibrotic conditions was examined, with single organ fibrosis serving as the reference group and adjustments for age and sex.

TAKEAWAY

• From 2012 to 2022, the estimated proportion of adults with fibrotic conditions rose from 13.23% (95% CI, 13.21%-13.26%) to 19.95% (95% CI, 19.92%-19.98%). Intestinal/pancreatic fibrosis and skeletal fibrosis co-occurred most frequently.
• The estimated prevalence of single organ fibrosis increased from 12.94% (95% CI, 12.92%-12.97%) to 15.39% (95% CI, 15.39%-15.41%) from 2012 to 2022, and the estimated prevalence of multiple organ fibrosis was 8.51% by 2022. The prevalence of single and multiple organ fibrosis was higher in women than in men, with the prevalence of multiple organ fibrosis being 9.37% vs 7.66% in 2022.
• Patients had a median of 14 and 21 primary care visits in the preceding year before the diagnosis of single organ or multiple organ fibrosis, respectively. Following diagnosis, healthcare utilisation fell in both groups.
• The risk for mortality rose with each additional fibrotic condition, with hazard ratios of 2.90 (95% CI, 2.87-2.93) for two conditions and 8.79 (95% CI, 8.61-8.99) for four or more conditions compared with single organ fibrosis.

IN PRACTICE

"Earlier intervention by general practitioners leading to earlier diagnosis inevitably provides an opportunity for people to receive appropriate care at the earliest opportunity. It is also important that general practitioners are equipped with the resources to help these people with multiple fibrotic conditions, which often present as complex cases," the researchers wrote.

SOURCE

The study was led by Georgie May Massen, School of Public Health, Imperial College London, London, England. It was published online on September 22, 2026, in BMJ Open.

LIMITATIONS

The researchers could not account for ethnicity, deprivation, or lifestyle factors, which may be associated with the risk for fibrosis. Some cases may have been missed or misclassified because diagnoses relied on routine clinical coding.

DISCLOSURES

The study was supported by a grant from the Medical Research Council-UK Research and Innovation. Some authors reported receiving grants, consulting fees, or personal fees and serving on the advisory board of multiple pharmaceutical and biotechnology companies. One author disclosed serving on the advisory board of and holding shares in patientMPower.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.