Big increase forecast in liver cancer: Male incidence to rise 43 percent in 10 years

A rising prevalence of chronic hepatitis B and C in Australia, less than optimal screening and poor uptake of antiviral treatment are contributing to a significant rise in liver cancer in Australia, according to research published in Cancer Forum.

In an article for the July issue of Cancer Forum (Vol. 33, issue 2), Doctor Monica Robotin from Cancer Council NSW reports incidence rates in NSW are rising "faster than any other cancer".

While greater than other states, the rise in NSW was indicative of rising rates across the country, with national rates forecast to increase 27% in females and 43% in males in the 10 years to 2011.

The July issue of Cancer Forum takes an in-depth look at liver cancer, covering risk factors, incidence/mortality trends and issues around screening and treatment uptake.

Addressing the contentious issue of screening, Associate Professor Edward Gane, from the New Zealand Liver Transplant Unit, argues that delayed diagnosis has led to an "abysmal prognosis" for liver cancer rates in the region, with annual mortality currently exceeding incidence.

Most patients presented with advanced disease, with five-year survival at less than 20%, yet earlier diagnosis could lead to significantly better outcomes. "The natural history of small hepatocellular carcinomas (1–3 cm) is vastly different, with five-year survival exceeding 50%," wrote Prof. Gane.

In an article on treatment uptake and advanced disease burden, Professor Gregory Dore and Doctor Hla-Hla Thein, from the National Centre for HIV Epidemiology and Clinical Research, estimate that less than 3% of people with chronic hepatitis B are on anti-viral medication. This represented an "extremely low" uptake that would have a major impact on liver cancer incidence.

Despite the bleak prognosis, Guest Editors Professor Jacob George and Doctor Robotin highlight the availability of effective therapies to either eradicate or suppress viral hepatitis that will translate to a reduced incidence of liver cancer, as well as the anticipated arrival of new, more effective targeted therapies, with fewer side-effects and less anti-viral resistance. "We are clearly at the threshold of a better and brighter future for this previously untreatable malignancy," they wrote.

(Source: Cancer Council NSW: Cancer Forum: June 2009)