Study Shows Most Cases of Liver Cancer Can Be Prevented

In 2015 alone there were 854,000 cases of liver cancer and 810,000 deaths globally, but most can be prevented, according to new research.

A study published in JAMA Oncology has found that the most common causes of liver cancer are hepatitis B virus (HBV), hepatitis C virus (HCV), and alcohol use, and as such most cases of liver cancer, one of the leading causes of cancer deaths globally, are preventable through several measures, including vaccination and reduction of excessive alcohol use.

The study compiled results of the 2015 Global Burden of Disease (GBD) study on primary liver cancer occurrence, mortality, and disability-adjusted life-years in 195 countries and territories from 1990-2015. The study also analyzed present global, regional, and national estimates on the burden of liver cancer accredited to HBV, HCV, alcohol use, and an “other” category.

One of the biggest barriers to prevention of liver cancer is the amount of time that passes between exposure to the risk factor and the development of the cancer, the researchers explained.

“The analysis of liver cancer as part of the Global Burden of Disease 2015 study therefore serves 2 main purposes,” wrote the authors. “First, to provide detailed information on liver cancer etiologies and their trends overtime, without which targeted prevention strategies are impossible to design and to evaluate; and second, to promote strategic investments into research and clinical trials.”

The study found that the highest burden of cancer incident cases, deaths, and disability-adjusted years were in East Asia. Between 1990 and 2015, the amount of liver cancer incidents grew by 75%. Of the 854,000 cases of liver cancer, men accounted for 591,000 while women accounted for 264,000.

At a global level in 2015, HBV was the leading cause of incident cases of liver cancer deaths, accounting for 33%, followed by alcohol with 30%, HCV with 21%, and other causes with 16%.

“As a part of the GBD 2015 study, we estimated the burden of liver cancer due to the main causes at the global, regional, and national levels to inform strategic planning of prevention programs, as well as research and health system resource allocation,” wrote the authors.

Focusing on time trends allowed the authors to find that, at a global level, liver cancer caused by HBV and other causes would have declined between 1990 and 2015 if the demographic profile and population size had stayed the same. Liver cancer caused by HCV and alcohol consumption would have increased because of the rise of age-specific rates.

The results showed that through vaccination, antiviral treatment, safe blood transfusions, and injection practice, and precautions made to reduce excessive alcohol consumption, more cases of liver cancer can be prevented. It is estimated that the number of HBV infections will drop by approximately 70% if HBV vaccination trend continue.

However, due to population aging and growth, there is a likelihood that the amount of liver cancer cases will increase, creating a need for secondary prevention, such as ensuring availability of interventional radiology, pathology, surgical, and palliative care specialties.