The rate of liver cancer has been increasing in the U.S. — 38 percent between 2003 and 2012.
Texas has the highest incidence in the country of the most common form of liver cancer. The reason likely stems from a cluster of risk factors for the disease.
Dr. Amit Singal is an associate professor of internal medicine at UT Southwestern Medical Center.
What’s behind the increase in liver cancer: We think this is really related to a clustering of risk factors. The most common risk factor in the United States is chronic hepatitis C. Patients born between 1945 and 1965 are very high risk for having chronic hepatitis C. These patients are now aging to the point where they have severe underlying liver disease or cirrhosis, and they’re at high risk for developing primary liver cancer.
Another common risk factor: Nonalcoholic fatty liver disease is a liver disease that’s related to being overweight or having underlying diabetes. This can cause cirrhosis. This can cause liver cancer – just like drinking, just like hepatitis C, just like hepatitis B. Many people don’t understand that; they’re unaware of that. This is one of the most common causes now, and it’s rapidly increasing.
Why is the level of hepatitis C so high in the U.S.: Many of these baby boomers went through a period where we didn’t actually recognize hepatitis C; we didn’t know about it. And so any kind of blood exposure that people received during their childhood, even into their 20s and 30s, you were at risk for acquiring hepatitis C.
In the 1970s, 1980s, there was a lot of IV drug, intranasal cocaine, that was going on, and these are risk factors for acquiring hepatitis C. The other thing is even if you received a blood transfusion in the 1970s, 1980s, that could have also been a risk factor for acquiring hepatitis C.
Why is there a high rate of primary liver cancer in Texas? It’s a probably a clustering of these same risk factors. The other thing is probably genetics. We actually have a higher Hispanic population than other parts of the country, and Hispanics have a genetic predisposition to developing non-alcoholic fatty liver disease.
Lowering the risk against liver cancer: We don’t have good chemo preventive agents, so we can’t give you a medication to help reduce your risk of primary liver cancer. The only thing we can try to do is prevent the risk factors. There are effective treatments where we can cure hepatitis C. That can reduce your risk of primary liver cancer.
Similarly, we would recommend you not drink heavily. We would recommend overweight people to diet and exercise and lose weight, so you could correct your underlying liver disease, and thereby, reduce your chance of developing primary liver cancer.
This interview has been edited for brevity and clarity.
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