For many years, October was designated as Liver Awareness Month in the United States. This year I noticed that the American Liver Foundation and the Global Liver Institute were referring to the event as Liver Cancer Awareness Month. I saw a few sites that are still using the broader term, Liver Awareness Month. I am not sure which is true, so I’m covering my bases. Last week I wrote about Liver Awareness Month; this month it will be on Liver Cancer Awareness Month.

Now that the trivial stuff is out of the way, let’s get down to what is truly important: liver cancer. While the incidence of most cancers are declining in the United States, the rate of hepatocellular carcinoma (HCC or liver cancer) is increasing. More than 40,000 people in this country will be diagnosed this year with primary liver cancer, facing a 5-year survival rate of only 18 percent. According to the National Cancer Institute, liver cancer is the fifth leading cause of cancer death. Worldwide, it is the second leading cause of cancer death.

Despite the grim statistics, liver cancer is highly preventable. For instance, treating hepatitis C, immunizing against hepatitis B, managing fatty liver disease, and conducting regular liver disease screening could dramatically alter the trajectory we are on.  If caught early, HCC can be treated successfully, so obviously it’s critical to screen people who are at risk.

In August 2018, the American Association for the Study of Liver Diseases (AASLD) published the latest practice guidelines regarding HCC. The Diagnosis, Staging, and Management of Hepatocellular Carcinoma: 2018 Practice Guidance by the American Association for the Study of Liver Diseases by Jorge A. Marrerom et al, is available at the AASLD website.

People who are at increased risk for HCC are those with cirrhosis, regardless of the liver disease that led to the cirrhosis. Other conditions that need to be monitored:

  • Hepatitis B carrier with or without cirrhosis need to be monitored for HCC
  • Hepatitis C cirrhosis or stage-3 fibrosis

Liver cancer surveillance is pretty much noninvasive. Generally it relies on blood tests and ultrasound examinations of the liver every 6 months. Performed regularly, this significantly increases the number of cancers that are found at early stages and substantially improves the chances of surviving HCC.