Preventing Most Cases of Liver Cancer: Here's the Way to Achieve It
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The Lancet Oncology Liver Cancer Commission has released a series of recommendations aimed at reducing the global incidence of liver cancer, a growing health problem that is currently the third leading cause of cancer deaths worldwide.
According to the Commission, many cases of liver cancer can be prevented, and patient survival rates improved, through joint and sustained efforts. Compared to other types of cancer, liver cancer is difficult to treat, with a five-year survival rate ranging from 5 to 30%.
The Commission's key recommendations focus on preventing modifiable risk factors through multiple strategic actions.
- Intensify hepatitis B virus (HBV) vaccination programs, including vaccine mandates in countries with high prevalence, and implement universal HBV screening for adults over 18. Additionally, selective hepatitis C virus (HCV) screening in high-risk regions based on cost-effectiveness should be considered.
- Enact policies to reduce alcohol-related liver cancer risk, such as minimum alcohol unit pricing, risk warning labels on alcoholic beverages, and restrictions on alcohol advertising.
- Increase public awareness through national health education campaigns and prioritize early detection resources for liver cancer to improve outcomes and reduce late-stage diagnosis.
- Provide comprehensive palliative care training to hospitals and professional organizations, aiming to integrate such care early in the patient treatment pathway to enhance quality of life.
- Encourage healthcare providers to incorporate routine screening for liver damage in populations at high risk for metabolic dysfunction-associated steatotic liver disease (MASLD), including those with obesity, diabetes, or cardiovascular disease, along with lifestyle counseling to promote healthy diets and regular physical activity.
- Address regional disparities in liver cancer clinical management by fostering collaboration between professional organizations and the pharmaceutical industry, especially to bridge gaps between Eastern and Western healthcare practices.
The Commission emphasizes that about 60% of liver cancer cases are preventable through these targeted interventions, and achieving an annual reduction of 2 to 5% in incidence by 2050 could prevent 9 to 17 million new cases and save 8 to 15 million lives globally.
One-third of the world's population has metabolic dysfunction-associated steatotic liver disease (MASLD), where fat accumulates in the liver. The proportion of liver cancer cases related to MASH will increase from 8% in 2022 to 11% in 2050. Governments will need to invest in early detection of liver damage and cancer, and improve palliative care for patients.
More than 40% of liver cancer cases worldwide are in China due to relatively high hepatitis B prevalence. The proportion of liver cancer cases related to hepatitis B will decrease from 39% in 2022 to 37% in 2050, and those related to hepatitis C will decrease from 29 to 26%.
It is projected that the number of deaths from liver cancer will double from 760,000 in 2022 to 1.37 million in 2050. These comprehensive strategies highlight prevention, early detection, equitable care, and patient-centered treatment as pillars in combating the rising burden of liver cancer worldwide.
- The key recommendations from The Lancet Oncology Liver Cancer Commission also stress the importance of addressing mental health and nutrition in the fight against liver cancer, as poor diet and lack of exercise can contribute to metabolic dysfunction-associated steatotic liver disease (MASLD), a growing risk factor for liver cancer.
- In addition to preventing modifiable risk factors, updated medical-conditions guidelines must prioritize innovative research and treatments for chronic diseases such as cancer, focusing on improved health-and-wellness outcomes for patients with liver cancer.
- To this end, the Commission encourages healthcare providers to screen for mental health issues, such as depression and anxiety, in liver cancer patients, as mental health is crucial for overall health and fitness-and-exercise adherence.
- Furthermore, the impact of nutrition on health outcomes is evident, and thereby, nutritional support for liver cancer patients, with a focus on antioxidant-rich foods and supplements, should be explored as a potential avenue for improving survival rates and reducing recurrences.
