Posted online February 17, 2009, on www.jco.org .
A new study has shown that the incidence of liver cancer in the United States tripled between 1975 and 2005. Researchers also found that survival rates improved for patients diagnosed with liver cancer, as more patients were diagnosed at earlier stages, when the disease is more treatable. The study, by researchers at the National Cancer Institute, appears in the February 17, 2009 online edition of the Journal of Clinical Oncology.
Although the study could not determine why liver incidence rates are increasing, researchers believe that these trends may be partially due to an increase in chronic hepatitis C, which along with hepatitis B is a major risk factor for liver cancer. Other factors that may contribute to the increase in liver cancer include: heavy alcohol consumption, fatty liver disease, obesity, diabetes mellitus and iron storage diseases.
The study found that liver cancer rates increased by 306 percent over 30 years, from 1.6 to 4.9 cases of liver cancer per 100,000 people, between 1975 and 2005. Between 2000 and 2005, liver cancer rates increased most significantly among African-American, Hispanic and white men between 50 and 59 years of age. The researchers suggest that increases in this age group may be partially due to an epidemic of hepatitis C infection that occurred in the 1960s when they were young adults. While the increase in liver cancer incidence rates among Asians and Pacific Islanders was modest, rates remained vastly higher than other racial groups. This is likely due to higher rates of hepatitis B in these communities.
Researchers believe that earlier screening for patients at risk for liver cancer, including patients with cirrhosis, hepatitis B, and hepatitis C virus infection are likely to have contributed to increasing survival rates for liver cancer. When detected early, there are significantly more treatment options for liver cancer - in most cases, the earlier it is caught, the better the prognosis. This study points to the need to identify even more at-risk individuals through early screening programs to improve prognosis with potentially curative therapy.
Researchers suggest that because of a greater awareness of liver cancer and its risk factors, healthcare providers may be screening at-risk patients more frequently with tools such as such as abdominal ultrasound, allowing more patients to be diagnosed with early or asymptomatic disease.
What This Means for Patients
Researchers recommend that individuals who have risk factors for liver cancer talk to their doctors about screening, which will increase the likelihood of identifying liver cancer when it is early and most treatable. Risk factors for liver cancer include: hepatitis B or C infection, and perhaps heavy alcohol consumption, fatty liver disease, obesity, diabetes mellitus, and iron storage diseases.