The Primary Care Gap in MASH: Understanding Screening Barriers and the Path to Better Detection

In this episode, 'The Primary Care Gap in MASH: Understanding Screening Barriers and the Path to Better Detection,' Mazen Noureddin, MD, MHSc, FAASLD explores the following question:

What are the biggest barriers preventing primary care physicians from screening for MASH in their obese patients, and how can those barriers be addressed?

Noureddin acknowledged the extraordinary challenge facing primary care physicians who are tasked with managing a patient holistically across rapidly evolving fields and expressed genuine appreciation for the breadth of responsibility they carry. Acknowledging this, awareness of MASH screening guidance remains uneven, with a meaningful portion of primary care physicians not consistently applying the recommendation to screen high-risk patients with metabolic risk factors using the FIB-4 test. He also contextualized the recency of the screening guidance itself as a significant contributing factor to the current gap, noting that formal recommendations to screen high-risk populations, including patients with obesity, type 2 diabetes, or two or more metabolic risk factors, have only emerged in the last several years, meaning that many primary care physicians trained before these guidelines existed and may not have fully incorporated them into their routine practice. Noureddin expressed optimism that awareness is improving, pointing to the growing familiarity among primary care physicians with guidance from the ADA, AACE, and other major societies, and emphasizing that the path to closing the screening gap lies in continued education and the simplicity of the FIB-4 as a first-line tool.

Throughout the conversation, the experts provide a comprehensive reflection on the field and the factors that may shape how clinicians approach care moving forward.

The next episode in this series, 'GLP-1 Plus Glucagon: The Mechanistic Case for Dual Receptor Agonism in Obesity and MASH,' features Mazen Noureddin advancing his conversation on obesity and MASH and focusing on what makes a dual GLP-1/glucagon receptor agonist mechanistically distinct from GLP-1 receptor agonism alone.