3 in 5 liver cancer cases due to preventable risk factors, obesity-linked cases spiralling, says Lancet study: Why our lifestyle matters even more

Stephen Lam Chan from the Department of Clinical Oncology, University of Hong Kong, and other authors of the Commission have called for increased public, medical and political awareness about high-risk groups, including individuals with diabetes and obesity.

Current liver cancer burden in India

Dr Sheetal Dhadphale, Director, Hepatology and Transplant Medicine, Sahyadri Hospitals, Pune, said that the current incidence of liver cancer ranges from 2.15 to 2.27 per lakh of population while the mortality is 2.21 per lakh. “Liver cancers due to Hepatitis B are slightly decreasing but those related to alcohol and MASLD are increasing. Awareness campaigns and focussed treatments are necessary to combat this spiral,” she explained.

Liver cancer is amongst the fastest growing cancers, said Dr Shiv Kumar Sarin, founding director, Institute of Liver and Biliary Sciences (ILBS), New Delhi. He flagged concern over the rise in the number of people living with obesity, diabetes and fatty liver disease. “Studies have shown that for 100 cases of liver cancer, 35 to 40 are among those with diabetes and fatty liver disease,” he said.

What about liver screening?

Lancet authors advocate screening for liver damage into routine healthcare practice for patients in the high risk group. “Healthcare professionals should also integrate lifestyle counselling into routine care to support patients to transition to a healthy diet and regular physical activity. Furthermore, policy makers must promote a healthy food environment via policies such as sugar taxes and clear labelling on products with high fat, salt, and/or sugar,” they said.

Why public health policies need to target obesity, alcohol consumption

Liver cancer is already a major cause of death and disability. Globally, it’s the sixth most common cancer and the third leading cause of death from cancer. Chair of the Commission, Prof Jian Zhou, Fudan University (China) said, “Liver cancer is one of the most challenging cancers to treat, with five-year survival rates ranging from approximately 5 per cent to 30 per cent. We risk seeing close to a doubling of cases and deaths from liver cancer over the next quarter of a century without urgent action to reverse this trend.” According to Prof Chan, Chinese University of Hong Kong (Hong Kong, China), “As three in five cases of liver cancer are linked to preventable risk factors, mostly viral hepatitis, alcohol and obesity, there is a huge opportunity for countries to target these risk factors, prevent cases of liver cancer and save lives.”

How to reduce risk factors

The commission highlights several ways to reduce these risk factors, including increasing the coverage of the hepatitis B vaccine and public health policies targeting obesity and alcohol consumption. It even urges governments to intensify efforts for increasing HBV vaccination — such as vaccine mandates in high-prevalence countries — and implement universal HBV screening for adults 18+, alongside targeted HCV screening in high-risk areas. Policy makers should enact minimum alcohol unit pricing, warning labels and advertisement restrictions for alcoholic beverages.