Liver cancer: increased incidence driven by older patients with NASH

  • Liu Z & al.
  • Cancer
  • 23 Mar 2020

  • curated by Pavankumar Kamat
  • Univadis Clinical Summaries
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Takeaway

  • Primary liver cancer (PLC) rates have been increasing globally, and the increase has been driven by older individuals in developed countries, particularly those with nonalcoholic steatohepatitis (NASH). 

Why this matters

  • Liver cancer was estimated to be the sixth most commonly diagnosed malignancy and fourth leading cause of cancer-related mortality globally in 2018.

Study design

  • Annual incidence data (1990-2017) were collected from 195 countries and territories.
  • Data were also retrieved on 5 etiologies of liver cancer: HBV infection, HCV infection, alcohol use, NASH, and other.
  • Funding: National Key Research and Development Program of China; National Natural Science Foundation of China; Science and Technology Commission of Shanghai Municipality; and Shanghai Municipal Science and Technology Major Project.

Key results

  • An increasing trend was seen in most countries for PLC among individuals age 60 years.
  • The age-standardized incidence rates of PLC caused by the 5 factors increased significantly in most of the developed regions. 
    • The magnitude of increase was greatest for NASH-induced liver cancer.
  • Vaccination has “dramatically” decreased both the prevalence of HBV infection and the incidence of associated PLC among younger people in high-risk countries.
  • However, HCV infection has emerged as a concerning cause of liver cancer among individuals once believed to be at low risk.

Limitations

  • Potential bias from miscoding, underreporting, and underestimation of liver cancer.
  • Multietiological liver cancer was not considered.