Liver cancer: cases to double by 2050, a disease that can be avoided through prevention

Improved hepatitis B vaccination coverage and policies targeting obesity and alcohol consumption are needed to reduce the number of liver cancers, which, without public action, could almost double worldwide by 2050, according to an international study published on Tuesday, July 29.

This work, carried out by a commission of experts from six countries (China, the United States, South Korea, Italy, Spain and France, with which Inserm collaborated in particular), and published in the medical journal The Lancet , underlines "the urgency of global action" against this disease, after having scrutinized the available studies and data.

Liver cancer is the sixth most common cancer and the third most deadly. According to the World Cancer Observatory, worldwide, by 2050, the number of new cases will rise to 1.52 million per year, a near doubling, while 1.37 million people will die from it.

Eight out of ten of these cancers are hepatocellular carcinomas, a form particularly prevalent in East Asia, North Africa, and Southeast Asia. Globally, the five-year survival rate for patients ranged from 5% to 30% between 2000 and 2014.

However, three out of five liver cancers are due to preventable risk factors that researchers believe should be addressed: viral hepatitis, alcohol consumption and non-alcoholic fatty liver disease (characterized by an accumulation of fat in the liver, often associated with obesity).

Hepatitis B and C viruses are expected to remain the main causes of liver cancer in 2050, while seeing their share decrease (36.9% of cases compared to 39% for the former, 25.9% compared to 29.1% for the latter).

While hepatitis B vaccination is the most effective means of prevention, "coverage remains low in Africa and in low-resource regions" due to its "cost, reluctance to be vaccinated and lack of awareness of its effectiveness" and the lack of mandatory vaccination, the study says.

"In 2015, vaccination of newborns and infants prevented 210 million new chronic hepatitis B infections and is expected to reduce the estimated number of deaths to 1.1 million by 2030," the researchers report.

If this vaccination is not reinforced, "17 million deaths linked to hepatitis B are expected to occur between 2015 and 2030," they say.

The proportion of liver cancers due to alcohol consumption and steatosis is expected to increase: the accumulation of fat in the liver will be the cause in 11% of cases in 2050 (compared to 8% in 2022), an increase of 35%, and alcohol, in 21.1% of cases by this time, according to their calculations.

Consequently, the study's authors call for raising awareness among the public, medical communities and governments about the growing risk of steatosis, "particularly in the United States, Europe and Asia," with a focus on "high-risk groups: diabetics and obese people."

"Improving patient survival must be a major focus of research," says the study, which calls for "coordinating efforts" between industry, healthcare providers, and international organizations to reduce the significant disparities in disease management, which is very inadequate in low- and middle-income countries.