Liver Cancer Prevention: New Report Highlights Obesity as Rising Risk Factor
A comprehensive new report published July 28 in The Lancet reveals that at least 60% of liver cancer cases worldwide are preventable, with a growing emphasis on addressing risk factors like obesity and its associated metabolic dysfunction-associated steatotic liver disease (MASLD). The findings, released to coincide with World Hepatitis Day, underscore the urgent need for preventative measures as the global burden of liver cancer is projected to surge.
Global Liver Cancer Cases Projected to Rise
The report projects a significant increase in both new liver cancer cases and related deaths. By 2050, the number of new cases is expected to reach 1.52 million, with 1.37 million resulting in fatalities. This alarming forecast highlights the critical importance of proactive intervention.
MASLD: A Growing Threat
A particularly concerning trend identified by the commission is the anticipated 35% increase (ranging from 8% to 11%) in liver cancer cases attributable to metabolic dysfunction-associated steatohepatitis (MASH), a severe form of MASLD. This rise is directly linked to increasing rates of obesity, particularly in the United States, Europe, and Asia.
Call for Increased Awareness and Action
The commission is calling for a concerted effort to raise awareness among the public, medical professionals, and policymakers regarding the escalating risk posed by MASLD. A specific focus is recommended for high-risk groups, including individuals with diabetes and/or obesity. Without urgent action, the number of new liver cancer cases is predicted to double over the next 25 years. To combat this, the commission has set a target of achieving a 2%-5% annual reduction in new cases, a goal that could potentially prevent up to 17 million cancer diagnoses and 15 million deaths.
Ten Strategies to Reduce the Global Burden
The commission outlined ten key strategies for reducing the global impact of liver cancer and improving patient quality of life:
- Strengthening prevention, screening, and treatment for viral hepatitis, including integrating hepatitis B virus vaccination into national immunization schedules and targeted hepatitis C virus (HCV) screening.
- Implementing “strong government-led measures” to reduce alcohol consumption, such as warning labels and restrictions on advertising.
- Controlling environmental risk factors, particularly exposure to contaminated water and aflatoxins in food in low- and middle-income countries.
- Developing tailored national strategies for awareness, screening, and management of the increasing prevalence of MASLD and MASH.
- Raising awareness of liver health among policymakers and the general population.
- Improving early hepatocellular carcinoma (HCC) detection through optimized surveillance tests and technologies.
- Standardizing noninvasive HCC diagnoses with consistent criteria for interpreting imaging studies.
- Addressing regional differences in clinical management through collaboration between professional organizations and the pharmaceutical industry.
- Improving HCC survivorship through research, clinical documentation, and the integration of palliative care.
- Facilitating access to treatment for HCV and HCC, currently limited by high costs and lack of cost-effectiveness.
Obesity’s Central Role in Liver Cancer Development
The report emphasizes a significant shift in the understanding of liver cancer etiology. “Liver cancer was once thought to occur mainly in patients with viral hepatitis or alcohol-related liver disease,” explained a commission author from Baylor College of Medicine in Houston. “However, today rising rates of obesity are an increasing risk factor for liver cancer, primarily due to the increase in cases of excess fat around the liver.”
The commission recommends incorporating liver damage screening into routine healthcare for individuals at high risk for MASLD, including those with obesity, diabetes, and cardiovascular disease. Healthcare professionals are also encouraged to provide lifestyle counseling to promote healthy diets and regular physical activity. Furthermore, policymakers are urged to create supportive food environments through measures like sugar taxes and clear product labeling.
A Message of Hope and Possibility
In a related editorial, The Lancet editorial board concluded that strengthening prevention, fostering collaboration, and removing barriers to knowledge can help avert the rapid rise of liver cancer. “Taking action to realize that possibility is vital for the health of many millions of people worldwide over the next 25 years.”
The Commission’s work was supported by grants from the Natural Science Foundation of China, Noncommunicable Chronic Diseases-National Science and Technology Major Project, and Shanghai Municipal Science and Technology Major Project. A complete list of authors and any competing interests is available within the full report.
