October is Liver Cancer Awareness Month. Raising public awareness is vital in improving outcomes for patients with primary liver cancer. Prevention and early detection through immunisation, surveillance programmes, education and health promotion are key in the battle against this disease.
The National Cancer Registry of Ireland reported 344 new cases of liver cancer and 398 deaths from liver cancer per year 2018-2022. Over the last decade there has been a 300% increase in the number of liver cancer cases annually in Ireland(1).
Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer, accounting for approximately 90% of cases worldwide. The most common risk factor for liver cancer is chronic liver disease and cirrhosis, secondary to insults such as non-alcoholic fatty liver disease (NAFLD), viral hepatitis, alcohol abuse, or haemochromatosis.
Health Promotion and Primary Prevention
Prevention of liver cancer requires awareness of the risk factors for its development, in particular chronic liver disease and cirrhosis. Globally, viral hepatitis is the leading cause of liver cirrhosis, however fatty liver and alcohol excess are the leading risk factors in the western world.
Obesity is linked with NAFLD and liver cirrhosis. It is associated with a 1.5 – 4.5 times higher risk of hepatocellular carcinoma (HCC). Weight loss and increased physical activity improve outcomes for patients with non-alcoholic fatty liver disease (NAFLD), reducing the risk of progression to cirrhosis.
Alcohol is a group 1 carcinogen, linked to several cancers, including liver cancer. Whilst there is no safe level of alcohol consumption, current low-risk guidelines recommend less than 11 standard drinks per week for women and 17 standard drinks per week for men. For more information on steps you can take to reduce cancer risk with alcohol you can read the article linked here.
Quitting smoking can also reduce the risk of HCC, with many resources available through the HSE website to help people stop smoking e.g. www.quit.ie (Tel: 1800 201 203). Click here to access resources.
Vaccination against HBV, and treatment of HBV and Hepatitis C virus with anti-viral therapies to reduce liver scarring, can help prevent viral hepatitis associated HCC.
This October we hope to shine a light on liver cancer here in Ireland, as liver cancer rates are increasing. Surveillance for early diagnosis of HCC, and specialist Multi-Disciplinary Team treatment are both important. However, prevention is better than cure! Further information is available from the Irish Liver Foundation (www.liverfoundation.ie) and the Irish Cancer Society (www.cancer.ie).
Author: Michèle Bourke, Hepatocellular Carcinoma Advanced Nurse Practitioner, St. Vincent’s University Hospital, Dublin.
References:
(1) National Cancer Registry Ireland (2016) Cancer Trends. Available online at: National Cancer Registry Ireland (2016) Cancer Trends. Available online at: https://www.ncri.ie/sites/ncri/files/pubs/Liver%20trendsDecember2016_0.pdf Accessed on 08/08/2023.
