The Rising Challenge of Liver Cancer

Liver cancer is one of the only cancers in Australia where rates are rising. Most liver cancers have a preventable cause, and increasing screening and treatment for hepatitis B and C will help us to curb the rates of liver cancer.

Presented by Massimo Colombo, University of Milan, Milan, Italy

View the Abstract | View the Presentation

 

In 2015, liver cancer was the fourth leading cause of death after lung, colorectal and stomach cancer.

Hepatitis B accounts for 33% of liver cancer death, alcohol for 30%, hepatitis for 21% and other causes for 16%:

This means that 84% of the Liver cancer is preventable.

Surveillance of hepatocellular carcinoma (HCC) in patients with cirrhosis is more cost effective (annual incidence ≥1.5%) than patients who have chronic hepatitis B (annual incidence ≥ 0.2 %): 

Editor's note: HCC can develop in patients with chronic hepatitis B without the presence of cirrhosis, so HCC screening guidelines in Australia are based on age - see B Positive for more information.

There is however a low surveillance rate of hepatocellular carcinoma in patients with cirrhosis even in the USA with an uptake rate of only 18%: 

My personal reflection as a GP from this session is that we should be encouraging our patients with hepatitis (B or C) and alcoholic liver disease to have regular hepatocellular cancer screening. While this is reccomended, it remains a challenge to engage these patients in regular screening and monitoring, especially when they live remotely or chaotically.