- The most common form of liver cancer
is on the rise in the United States, and the increase is expected to continue
until hepatitis B and C are brought under better control.
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- The incidence of hepatocellular carcinoma
increased 71 percent from the mid-1970s to the mid-1990s, according to
researchers at the Veterans Affairs Medical Center in Albuquerque, N.M.
Hospitalization and death rates for all types of liver cancer were also
found to be increasing at a similar pace.
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- Liver cancer will strike an estimated
14,500 Americans in 1999, according to the American Cancer Society. Most
of them will get hepatocellular carcinoma.
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- Hepatocellular carcinoma is nearly always
fatal; only 5 percent of sufferers are alive five years after diagnosis,
because the tumors usually are found only after the cancer has spread.
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- The cancer is often caused by chronic
hepatitis B and hepatitis C, viral diseases that lead to liver scarring,
known as cirrhosis, which in turn can lead to liver cancer. Hepatitis also
can cause other changes in liver cells that make them cancerous.
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- Alcoholism is another leading cause of
cirrhosis and liver cancer. But alcoholism is declining and hepatitis B
infections are slowing because of a vaccine and effective treatments. So
researchers believe most of the increase in liver cancer is due to hepatitis
C, a disease discovered a decade ago.
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- The study was published in Thursday's
New England Journal of Medicine.
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- Many Americans with hepatitis C got it
during the 1960s and '70s from transfusions before the blood supply was
cleaned up by 1992. The virus can also be spread between drug users sharing
needles, and in rare cases, through sex. In half of all cases, doctors
do not know how patients got it.
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- An estimated 4 million Americans are
infected with the hepatitis C virus, but no one knows the exact number
because it can take up to 30 years for symptoms to develop. There is no
vaccine and the only available treatment does not help the majority of
patients.
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- Scientists call hepatitis C a hidden
epidemic.
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- "A lot of people still don't know
they have it,'' said Dr. Jack Wands, a liver research expert at Brown University.
"I think it will continue to rise until we have either a vaccine or
an effective treatment.''
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- Doctors should test patients with hepatitis-induced
cirrhosis for liver cancer, because if tumors are caught early enough,
surgery can be successful, said Dr. Hashem El-Serag, lead author of the
study.
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- Hepatitis B is more infectious but is
easier to treat. It is spread through blood, sex or from mother to child
at birth. About 200,000 Americans are diagnosed each year. The vaccine
has been available since 1991.
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- Hepatitis A, a relatively mild form of
the virus, is not a risk factor for liver cancer. It is spread primarily
through contaminated food, such as shellfish from tainted water or restaurant
food that has been touched by infected employees.
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