Liver cancer cases are projected to nearly double by 2050, but experts say up to three in five instances worldwide are preventable.
This analysis highlights the growing threat of obesity-related liver disease.
- Liver cancer cases may nearly double to 1.52 million by 2050.
- Three in five global cases are linked to preventable factors like viral hepatitis, alcohol, and obesity.
- Metabolic dysfunction-associated steatotic liver disease (MASLD) is a rapidly growing cause.
- Targeted prevention strategies could save millions of lives.
Liver cancer is a formidable foe, with survival rates often as low as 5%. “We risk seeing close to a doubling of cases and deaths from liver cancer over the next quarter of a century without urgent action,” warns Jian Zhou, a professor at Fudan University in China and chair of the Lancet commission. The grim forecast paints a stark picture: cases could rise from 870,000 in 2022 to 1.52 million by 2050, with annual deaths climbing from 760,000 to 1.37 million. Yet, amidst these alarming numbers, experts assert that millions of lives hang in the balance, waiting for targeted prevention and policy reform.
A Shifting Risk Landscape
For years, liver cancer was largely linked to viral hepatitis and heavy alcohol consumption. However, the game has changed. Metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as non-alcoholic fatty liver disease, is emerging as a dominant threat. This condition, linked to obesity and poor metabolic health, is now the fastest-growing cause of liver cancer globally. Its more severe form, MASH (metabolic dysfunction-associated steatose), is projected to drive a 35% increase in liver cancers by 2050, moving from 8% of cases in 2022 to 11%.
MASLD affects a significant portion of the population, particularly in high-income countries where obesity rates are soaring. “MASLD is one of the most common liver conditions in Europe, affecting up to 25% of the adult population,” stated Beatrice Credi of the European Liver Patients’ Association. In the United States, over half of adults are expected to have MASLD by 2040, significantly elevating their liver cancer risk.
Dr. Hashem El-Serag, a professor at Baylor College of Medicine, notes the evolving profile of the disease. “Liver cancer was once thought to occur mainly in patients with viral hepatitis or alcohol-related liver disease,” he explained. “But with obesity on the rise, it is becoming an increasingly prominent risk factor, largely due to growing cases of excess liver fat.” While hepatitis B and C cases are predicted to decline due to vaccination and improved treatments, alcohol-related cancers are expected to rise modestly.
The Power of Prevention
Despite the dire predictions, the Lancet commission offers a beacon of hope: the immense potential of prevention. Experts believe that reducing new liver cancer cases by just 2% to 5% annually could prevent up to 17 million new cases and save 15 million lives by 2050.
“As three in five cases of liver cancer are linked to preventable risk factors,” said Stephen Chan, lead author of the study and a professor at the Chinese University of Hong Kong, “there is a huge opportunity for countries to target these risk factors, prevent cases of liver cancer, and save lives.”
Achieving this requires a global, multi-pronged approach. This includes expanding hepatitis B vaccination and screening for adults, alongside aggressive measures to combat obesity and alcohol misuse. Strategies such as taxes, warning labels on food and beverages, and improved food policies are crucial. The commission also advocates for integrating liver screening into routine care for individuals with obesity, diabetes, and heart disease, emphasizing the need for public education and accessible early detection tools.
A Global Call to Action
Across Europe, policy shifts are increasingly focusing on prevention and early detection. The European Union’s Beating Cancer Plan aims for 95% coverage of childhood hepatitis B vaccination and screening for pregnant women by 2030. It also champions healthier lifestyles and reduced exposure to risk factors like alcohol, tobacco, obesity, and diabetes.
A recent European Commission recommendation highlighted the importance of expanded uptake of preventive vaccines, such as HPV and hepatitis B, and better monitoring of vaccination rates. However, Beatrice Credi points to a powerful, often overlooked force: commercial interests. “Industries that profit from the sale of alcohol, unhealthy foods, and tobacco play a significant role in driving some of the liver cancer risk factors,” she stated. “Our policymakers must prioritize public health.” She noted that regulations targeting these influences are often weak, with tax measures on sugar-sweetened beverages being a notable exception.
While prevention is paramount, it’s not the sole answer. With more people living with liver cancer than ever, improved care, earlier diagnosis, and better patient support are urgently needed, especially in regions like Africa and Asia where the disease burden is highest and healthcare resources are strained. Valérie Paradis, a professor at Beaujon Hospital in France, suggests that effective prevention could also alleviate this burden. “Compared with other cancers, liver cancer is very hard to treat but has more distinct risk factors, which help define specific prevention strategies,” she observed.
