Liver diseases of all types are on the rise among middle-aged Americans, including alcoholic liver disease, viral hepatitis and fatty liver disease. According to a recent report from the U.S. Centers for Disease Control and Prevention (CDC), together, these illnesses are also causing a significant increase in liver-disease-related deaths and liver cancer among people ages 45 to 64 across the country, The Wall Street Journal reports.

This fall, the CDC reported that death rates for chronic liver disease and cirrhosis, or liver scarring, rose 31 percent among middle-aged Americans between 2000 and 2015. Cases of liver cancer also increased by more than 20 percent in the United States between 1990 and 2015.

Public health experts say the increase in liver disease and its related complications are likely the result of a number of risk factors among this age group — from heavy drinking and injection drug use to undiagnosed hepatitis C virus (HCV) infections among baby boomers, to rising rates of obesity (a major risk factor for non-alcoholic fatty liver disease, or NAFLD). The fact that fewer than 30 percent of baby boomers say they have ever been tested for viral liver disease, which often delays treatment, exacerbates the epidemic.

Meanwhile, as many as 100 million Americans are estimated to have fatty liver disease. Studies show NAFLD is most common among those in their 40s and 50s and can lead to a progressive form of liver disease known as non-alcoholic steatohepatitis, or NASH, which can lead to cirrhosis and an increased risk for cardiovascular disease. 

That said, recent reports show hepatitis C testing rates have increased nearly fivefold among middle-aged Americans over the last few years. U.S. hospitals have also begun to administer far less invasive tests, such as MRI scans and ultrasounds, to help diagnose liver diseases of all kinds with better accuracy. However, liver disease experts say that until such screening methods are better established, doctors should be on the lookout for classic risk factors among their patients.

Among middle-aged people, these risk factors include a history of obesity and diabetes, increased belly fat, high blood pressure and high cholesterol. Heavy drinking or a past history with injection drug use may also warrant testing. Screening is also recommended for anyone who received a blood transfusion before 1992, the year widespread screening for viral hepatitis in the blood supply began.