The incidence of being drawing an ascending trajectory worldwide: scientists project that 870,000 cases will be passed in 2022 to almost double in 2050. And although, to a large extent, this increase is due to the growth and aging of the population, there are also a handful of avoidable risk factors that spur this alce The Lancet. In fact, they point out, three out of five liver tumors are due to preventable causes, such as disease by associated with obesity, hepatitis viruses and alcohol consumption.
Experts call to act “urgently” to stop these risk factors and remember that it is one of “the most difficult to treat”: it is the most frequent sixth and has a five -year survival below 30%. “This tumor develops on a sick liver. It is a silent disease, which does not give symptoms until it is very advanced,” says María Reig, head of the Hepatic Oncology Unit of the Clinic Hospital in Barcelona. She has not participated in this investigation, which does sign other researchers from her hospital, but considers “very timely” the alert call to “raise awareness” about this tumor. In their conclusions, the authors of the article ask to accelerate against hepatitis viruses and reinforce awareness campaigns on the risks of alcohol consumption and the need to promote healthy lifestyle habits, such as physical exercise.
If nothing changes, the scenario in sight is little flattering: 1.52 million cases of these tumors in 2050. But there is a margin of improvement, especially if you take into account, explains this commission The Lancet On liver cancer, that 60% of these tumors are due to avoidable risk factors. Specifically, experts put the focus, for example, in the evolution of the disease linked to a metabolic dysfunction, which is growing throughout the globe. This ailment, which affects one in three adults, is characterized by an accumulation of fat in the liver and, in its most serious forms, also has levels of fibrosis and inflammation capable of triggering cirrhosis or. Scientists estimate that cases of liver tumor linked to the most serious forms of fatty liver will grow from 8% to 11% in 2050.
Another risk factor in the spotlight is alcohol consumption. Experts estimate that hígados tumors associated with this unhealthy habit will go from 19% in 2022 to 21% within 25 years. Reig points out that, indeed, alcohol is “liver damage”, but makes an important note: “The amount of alcohol cannot define the risk, there are people with punctual consumption that also develops disease.”
The hepatologist, who is also head of the Barcelona Research Group Clinic Liver Cancer (BCLC) of the IDIBAPS and director of the UB-BCLC chair of liver cancer, emphasizes the need to “work on the indirect stigma that liver cancer has”. That is why he prefers to talk about “modifiable risk factors instead of unhealthy.” Words matter, he says. Especially, in a tumor that the collective imaginary limits to very specific realities, such as excessive alcohol consumption. The reality is more complex and demonstrates that there are more causes behind this cancer, he points out. “It is important how we approach the problem. The point of consciousness and investing in education is key. If we penalize people, they are less likely to respond. We have to reach society from a different place, it is the objective of the chair: addressing the needs of the pathology with a holistic and complementary vision.”
And remember: “It remains a cancer with high mortality that is not diagnosed early, although there is early detection tests, such as ultrasound. The population must be aware of doctors and work the stigma: it is a silent cancer and we have to give them a voice.”
According to the commission of scientists, worldwide, the avoidable risk factor caused by most hepatic tumors remains the hepatitis virus: one in three oncological paintings in the liver are associated with the impact of these microbes. The estimates of the expert commission, however, draw a descending line in this trend and foresee that the proportion of liver cancer associated with hepatitis will reduce 39% in 2022 to 37% in 2050.
Urgent preventive measures
The claims of scientists signed by the article in The Lancet It is to achieve an annual reduction of the incidence of cases between 2% and 5%. And although it may seem like a modest figure, if achieved, up to 17 million diagnoses and 15 million deaths could be prevented.
Experts raise “the urgent need for preventive measures.” For example, reinforce vaccination against hepatitis B and early detection of infections for this cause. “The health authorities must implement the universal screening of HBB for adults over 18 at least once in a lifetime,” they claim. And they also propose, in high prevalence areas, to promote the early detection of the hepatitis C.
In Spain, specifically, there is a vaccination plan against hepatitis B and universal treatment for hepatitis C, but there is always a margin of improvement, Reig One of his research group, for example, found that people who had had hepatitis C, after healing this disease, increased weight and raised alcohol consumption. “Those who cure hepatitis C, do not heal the risk of developing liver cancer,” he says. In his study, Reig and his team pointed out that this patient profile can “benefit from intensive advice and pharmacotherapy to address obesity and alcohol consumption.”
Reducing alcohol consumption globally is another key strategy. In Spain, according to the Ministry of Health to adolescents from 14 to 18 years, the age of the intake of alcoholic beverage is in the 14 years. Experts propose to influence the sales prices of these products and incorporate warning labels on their risks.
Stop the fatty liver
Scientists also call to reinforce the detection and treatment of fatty liver disease associated with metabolic dysfunction before it reaches more advanced phases that advocate cancer. It is an invisible ailment, which does not usually give symptoms until it is advanced and hepatologists have been warning of an important infradiagnosis.
The good part, however, is that, if the accumulation of fat has not yet caused deep liver damage, it can be reversed. With healthy habits, such as weighting, healthy diet (such as Mediterranean) and exercising; But it has also been recently demonstrated that innovative drugs against obesity – mediums such as the famous Ozempic – are capable of causing that fat tank in the liver and stopping fibrosis.
Another issue that researchers underline is the need to advance in the personalized treatment of liver cancer and combat the inequalities between countries in access to the different therapeutic options. In this field, science advances and the revolutionary immunotherapy, which trains the body’s own defenses to attack malignant cells, has also entered liver cancer. But there are still 70% of these treatments.
“You have to look for personalized treatments. The area of immunotherapy has grown significantly and has contributed a radical change, but now we are trying to find out why there are patients who do not respond or who, although they respond to the beginning, end up falling,” says Reig. And also emphasizes the need to improve early detection. Above all, taking into account that 40% of patients are diagnosed in advanced stages of the disease.
