“Liver cancer causes a huge burden of disease globally each year,” senior author Isabelle Soerjomataram, MD, PhD, deputy branch head of cancer surveillance for the World Health Organization’s International Agency for Research on Cancer in Lyon, France, said in a release. “It is also largely preventable if control efforts are prioritized — major risk factors include hepatitis B virus, hepatitis C virus, alcohol consumption, excess body weight, and metabolic conditions including type 2 diabetes.” “Liver cancer remains a major health issue globally, and in some countries it is the first in new cancer cases and number of cancer deaths,” says Bassam Estfan, MD, a hematologist and oncologist at Cleveland Clinic, who was not involved in the study. “Preventing and managing liver cancer requires a global effort and good access to healthcare and treatment, which may be a challenge in many countries with high rates of liver cancer incidence,” he says.
An Estimated 28,000 People Die of Liver Cancer in the U.S. Each Year
Cancer that starts in the liver is called primary liver cancer, with the most common type being hepatocellular carcinoma (HCC). Some cases of HCC begin as a single tumor that continues to grow larger, and only late in the disease does it spread to other parts of the liver, according to the American Cancer Society. A second type appears to start as many small cancer nodules throughout the liver, which is most often seen in people with cirrhosis (chronic liver damage) and is the most common pattern in the United States.
More Than 900,000 People Were Diagnosed With Liver Cancer in 2020
To estimate the global burden of liver cancer and predict the number of cases and deaths in 2040, investigators pulled data on primary liver cancer cases and deaths from the International Agency for Research on Cancer’s GLOBOCAN 2020 database, which produces cancer incidence and mortality estimates for 36 cancer types in 185 countries worldwide. The predicted change in the number of cancer cases or deaths by the year 2040 was estimated using population projections from the United Nations. The authors found that in 2020 an estimated 905,700 people were diagnosed with liver cancer and 830,200 died of liver cancer globally. That places liver cancer among the top three causes of cancer death in 46 countries and among the top five causes of cancer death in nearly 100 countries, including several high-income countries. Liver cancer incidence and mortality rates were highest in East Asia, North Africa, and Southeast Asia. After analyzing the current number of cases along with population data, the authors predict that if current trends continue, the annual number of new cases and deaths from liver cancer will rise by more than 55 percent over the next 20 years.
The Number of People Diagnosed With Liver Cancer Could Increase by Nearly a Half Million People by 2040
“The number of people diagnosed with or dying from liver cancer per year could increase by nearly 500,000 cases or deaths by 2040 unless we achieve a substantial decrease in liver cancer rates through primary prevention,” said Dr. Soerjomataram. How substantial? The authors estimate that countries across the world must achieve at least a 3 percent annual decrease in liver cancer incidence and mortality rates through preventive measures. For that to be possible, public health officials need to prepare for the predicted increase in demand for resources to manage the care of liver cancer patients and to reinforce current liver cancer prevention measures, the authors write.
Liver Cancer Is Often Preventable
These findings are significant because liver cancer is often a preventable disease, says Estfan. “Its incidence and mortality follow closely the global prevalence of its underlying causes. Hepatitis B and C infections from blood transfusion is not an issue anymore thanks to routine testing, but both can be transmitted through contaminated needle sharing (illicit drug use), and hepatitis B can be transmitted through unsafe sexual contact,” he says, adding that both of these routes are preventable. Hepatitis B can be transmitted from infected pregnant mothers to their newborns, which can also be prevented, says Dr. Estfan. According to the Centers for Disease Control and Prevention (CDC), perinatal transmission of hepatitis B can be prevented if the infection is identified and infants are treated within the first 12 hours after birth.
Liver Cancer Is Less Common in the U.S.
Liver cancer is more common in other parts of the world than in the United States, where it is actually declining, according to the CDC. About 25,000 men and 11,000 women in the United States get liver cancer each year, and about 19,000 men and 9,000 women die from it. “In the U.S., most underlying causes of liver cancer are related to hepatitis C infection and alcohol consumption, with an increasing, albeit modest, rate of nonalcoholic fatty liver disease,” says Estfan. The rates are going down because the rate of those aging with hepatitis C is decreasing, and with it the rates of incidence and mortality as well, he says. Alcohol abuse can lead to liver cirrhosis and increased risk of liver cancer, and abstinence or moderate use is important to prevent that, says Estfan. “One rising cause of fatty liver and cirrhosis is nonalcoholic fatty liver disease, often a result of obesity, hypertension, high cholesterol, and diabetes,” he says. “These are manageable conditions through healthy lifestyle and medical management.”
Tips to Keep Your Liver Healthy
If you have liver disease or you’re at risk of liver disease because of your family history or underlying medical conditions, it’s essential to maintain regular medical follow-ups with your liver doctor or primary care doctor and to take your medications as directed. The CDC offers the following additional tips to help reduce your risk of liver cancer:
Limit your alcohol consumption. The guidelines suggest that men drink no more than two alcohol units per day, and women no more than one.Maintain a normal weight. This can cut down on the risk of developing fatty liver disease or the risk factors that are associated with developing fatty liver disease.Don’t smoke. Or quit if you do.Get vaccinated against hepatitis B.Get tested for hepatitis C. And get medical care if you have it.
