World Cancer Day was observed on Saturday, February 4. Although the observance day has some and gone, cancer hasn’t; especially liver cancer. A recent article published by JAMA* reported that between 1980 and 2014, cancer mortality decreased by 20 percent in the United States. The number of deaths from nearly all the major forms of cancer have decreased significantly. The exceptions are liver, kidney, and non-Hodgkin lymphoma (NHL). Deaths due to NHL and kidney cancer remained the same. Liver cancer increased by 87.6 percent.  

This is quite disturbing. The number of deaths from lung cancer dropped by nearly 69 percent; colon cancer dropped by 35 percent; breast cancer by 32 percent. Liver cancer is not following the trend.

It isn’t just in the US. World Hepatitis Alliance CEO, Raquel Peck wrote that 800,000 people died worldwide from liver cancer last year (Preventing Cancer Before It Strikes). Of these, 642,500 were related to hepatitis B and C virus. Actually, hepatitis C may cause many more cases of cancer and death from it than are captured by the data. First, risk of death is increased for all causes of mortality including other types of cancer among people with hepatitis C. Second, we know that people with hep C are at increased risk for risk of non-Hodgkin lymphoma and kidney cancer. These are the two other cancers mentioned in the JAMA article that did not decrease in incidence between 1980 and 2014.   

In order to reduce the risk of liver cancer, we have to treat people with hepatitis C sooner, before they reach cirrhosis. However, if you already have cirrhosis, talk to your doctor about liver cancer screening recommendations. In the US, screening includes imaging (ultrasound, CT, or MRI) every 6 months.

If you have hepatitis B, your liver does not need to be cirrhotic in order to be at risk for liver cancer. Talk to your doctor about the current cancer screening recommendations for your risk factors.

People with hepatitis C tend to have a higher risk for non-Hodgkin lymphoma in the early stages, before the liver is cirrhotic. This is one reason why we need to ramp up our viral hepatitis prevention message, screen more people and treat them in the earliest stages of hepatitis C.

The JAMA article pointed to obesity and poor diet as factors that may be fuelling the incidence of cancer. These lifestyle-related factors certainly have been implicated in liver cancer. Non-alcoholic fatty liver disease (NAFLD) is quickly becoming the most common liver disease in the United States. People with NAFLD are at increased risk of liver cancer. The same is true for alcoholic liver disease.

So, don’t wait around wondering if you might get liver cancer. Here are some ways to reduce your risk:

  • If you haven’t had hepatitis B or been immunized against it, get vaccinated.
  • If you have hepatitis B, talk to your doctor about how to manage it.
  • If you have any risk factors for hepatitis C, get tested and then treated if you have it.
  • Don’t drink too much alcohol.
  • Maintain a healthy weight and prevent diabetes.
  • Eat a low-fat, high nutrition
  • Aim for regular physical activity.
  • If you have cirrhosis or other risk factors for liver cancer, talk to your medical provider and ask about regular cancer surveillance.

#WeCanICan stop liver cancer. 

*Trends and Patterns of Disparities in Cancer Mortality Among US Counties, 1980-2014 by Ali H. Mokdad, PhD, Laura Dwyer-Lindgren, MPH, Christina Fitmaurice, MD, MPH  JAMA 2017