A new study encourages health care professionals to provide personalized care to African Americans to help reduce their risk for severe liver fibrosis, or liver scarring, which can give rise to cirrhosis, liver failure and the need for a transplant. Hepatitis B, hepatitis C, fatty liver disease and heavy alcohol use can all cause fibrosis.

Conducted by researchers at RUSH University Medical Center in Chicago, the study aimed to determine who experienced liver fibrosis, factors that may drive its progression and whether cases had increased in the past two decades.

“We treat a very diverse population at RUSH, and I started to notice that different people had different liver scarring characteristics,” said study author Costica Aloman, MD, a RUSH transplant hepatology specialist, in a RUSH news release. “I was very interested in learning more about what the drivers of these differences are.”

The study analyzed data on more than 47,000 individuals who took the National Health and Nutrition Examination Survey between 1999 and 2018. Findings published in the Journal of Hepatology, showed that during this period, liver fibrosis cases more than doubled. What’s more, researchers found that liver fibrosis disproportionately affected certain racial and ethnic groups and that the prevalence of the condition and its causes changed over time.

Non-Hispanic Black men and women had higher rates of advanced liver fibrosis compared with white men and women, according to the study. Researchers note that race- and ethnicity-based factors influence the likelihood of developing the disease.

For example, risk factors that impacted Black participants disproportionately compared with whites included poverty and exposure to lead and cadmium. Researchers also note that from 1999 to 2018, alcohol consumption—which can increase the risk of developing advanced liver fibrosis—nearly doubled among the Black population.

To reduce the rate of liver fibrosis and achieve better health outcomes among African Americans, the study’s authors suggest addressing risk factors such as smoking, excessive drinking, poverty and exposure to environmental toxins. They also recommend expanding liver care services and increasing screening during primary care visits to catch the condition in its early stages to stave off disease progression.