Hepatitis-Caused Deadly
Liver Cancer On The Rise
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.
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.
Liver cancer will strike an estimated 14,500 Americans in 1999, according to the American Cancer Society. Most of them will get hepatocellular carcinoma.
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.
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.
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.
The study was published in Thursday's New England Journal of Medicine.
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.
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.
Scientists call hepatitis C a hidden epidemic.
"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.''
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.
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.
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.