Liver Cancer

Epidemiology of Cancers: Liver Cancer

Description
Types of primary liver cancer

  • Hepatocellular carcinoma (HCC) - The most common form of primary liver cancer in the UK accounting for 85% of all cases.
  • Hepatoblastoma (rare - affects children <4 years of age).
  • Angiosarcoma or haemangiosarcoma (rare - accounts for only 1% of all primary liver cancers and is more common in people aged >70).
  • Cholangiocarcinoma - cancer of the bile duct (rare, approximately 600 cases per year in the UK).

Symptoms

Symptoms may include:

  • Pain in the abdomen
  • Abdominal swelling
  • Anorexia
  • Weight loss
  • Jaundice - common in bile duct cancers.

Epidemiology

  • Liver cancer is one of the most common cancers worldwide.
  • An estimated 80% of all liver cancers occur in developing countries and reflects the high prevalence of hepatitis B (HBV) and hepatitis C virus (HCV) in these countries.
  • The incidence of liver cancer in persons <45 years is higher in developing countries than in developed countries.
  • In 2002, 2,783 cases or primary liver cancer were diagnosed in the UK (1,687 in males and 1,096 in females).
  • This incidence increased with increasing age with the majority of cases occurring in persons aged >50 years.
  • Between 1975 and 2002 the age standardized incidence rates in the UK have more than doubled from 1.4/100,000 to 3.5/100,000 population1.
  • Liver cancer causes around 2,700 deaths each year in the UK.
  • Prognosis for liver cancer is poor.

Risk Factors

  • Chronic infection with the hepatitis B virus (HBV).
  • Chronic infection with the Hepatitis C virus (HCV).
  • Chronic infection with HBV and HCV accounts for an estimated 80% of all liver cancers worldwide.
  • Sex - HCC is about 3 times more common in males than in females, although much of this may be due to differences in behaviours affecting risk factors.
  • Alcoholic cirrhosis.
  • Dietary aflotoxins.
  • Smoking.
  • Opisthorchis viverrini  infection - endemic in South East Asia (particularly Thailand) is the leading cause of  cholangiocarcinoma worldwide.
  • BRCA1 and BRCA2 mutations - linked to a moderate increased risk of primary liver cancer.

Screening and Prevention
Primary liver cancer is not a candidate for a population based screening programme; it is relatively rare and no completely accurate screening test for liver cancer exists. 

References

1.  Cancer Research UK

© CM Kirwan 2006