Summary of a study published online February 17, 2009 in the
Journal of Clinical Oncology,
showing that hepatocellular carcinoma (liver cancer) incidence and
mortality have increased substantially in the United States over the
past three decades, but survival rates are improving
Quote for attribution from Jennifer Obel, MD, American Society of Clinical Oncology gastrointestinal cancer expert
Links to additional information on Cancer.Net, ASCO’s patient Web site
A new study examining data on incidence trends, mortality rates and
survival rates from the National Cancer Institute’s Surveillance
Epidemiology and End Results (SEER) cancer registries indicates that
the incidence of liver cancer in the United States tripled between 1975
Researchers also found for the first time that one- through five-year
survival rates improved significantly for patients diagnosed with liver
cancer between 1992 and 2005, in part because more patients were
diagnosed at earlier stages, when treatment is more effective. Earlier
diagnosis may be due to increasing awareness and screening to detect
localized disease in patients at risk for liver cancer.
“Although the study could not determine why liver incidence rates are
increasing, these trends may be partially attributable to an increase
in chronic hepatitis C, which together with hepatitis B is a major risk
factor for liver cancer,” said Dr. Sean Altekruse, an Epidemiologist
with the NCI’s SEER Program and the study’s lead author. “Additional
research into the factors related to this increase in incidence will be
vital to preventing these rates from rising further.” Dr. Altekruse
noted that heavy alcohol consumption, fatty liver disease, obesity,
diabetes mellitus and iron storage diseases may also contribute to the
increasing incidence of liver cancer.
The study found that between 1975 and 2005, liver cancer rates tripled,
from 1.6 cases per 100,000 people to 4.9 per 100,000. From 1992 to
2005, liver cancer incidence trends increased significantly:
African-Americans and Hispanics both experienced an approximately
67 percent increase in liver cancer incidence between 1992 and 2005
(4.2 to 7.0/100,000 and 4.8 to 8.0/100,000, respectively), and whites
experienced an approximately 50 percent increase in incidence (2.6 to
3.9/100,000) during this time period.
Between 2000 and 2005, incidence rates increased most markedly
among African-American men (42 percent, 28.7 to 40.8/100,000), Hispanic
men (43 percent, 23 to 32.8/100,000), and white men (43 percent, (11.5
to 16.5/100,000) 50 to 59 years of age. These increases may be
partially due to an epidemic of hepatitis C infection that began in the
1960s, when men in this age range were young adults.
From 1992 to 2005, liver cancer incidence rates among Asians and
Pacific Islanders were the highest of all racial groups overall;
however, rates increased by a relatively modest 17 percent (10.0 to
11.7/100,000) in this time period. Researchers attribute a substantial
portion of liver cancer cases in Asians and Pacific Islanders to higher
rates of hepatitis B among some Asian subgroups.
One-year survival rates nearly doubled between 1992 and 2005, rising
from 25 percent of patients to 47 percent. Dr. Altekruse points out
that while the increasing survival rates are encouraging, further
improvement is still needed, noting that one-year survival rates are
still below 50 percent.
ASCO Perspective Jennifer Obel, ASCO official and Attending Physician, NorthShore University HealthSystem
“Early screening for patients with hepatitis C, a leading risk factor
for liver cancer, has directly contributed to increasing survival rates
for patients living with liver cancer. When detected early, there are
significantly more treatment options for liver cancer – in most cases,
the earlier it is caught, the better the prognosis. This study points
to the need to identify even more at-risk individuals through early
screening programs to improve prognosis with potentially curative
Information from Cancer.Net, ASCO’s Patient Web site
The Journal of Clinical Oncology is the tri-monthly
peer-reviewed journal of the American Society of Clinical Oncology
(ASCO), the world's leading professional society representing
physicians who treat people with cancer.
ATTRIBUTION TO THE JOURNAL OF CLINICAL ONCOLOGY IS REQUESTED IN ALL NEWS COVERAGE.
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