Early Detection of Liver Cancer

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The prognosis for liver cancer, like most other cancers, depends strongly on how advanced the disease is when it is first diagnosed. We know about getting mammograms, Pap smears, and colonoscopies. But how many of us are familiar with early detection of liver cancer?

Most liver cancers are predictable. They start with cirrhosis, which is a scarring disorder caused by alcohol abuse, hepatitis, or other less common conditions. This is a serious condition that can cause liver failure by itself, but it can be successfully treated for many patients. References 1 – 3 recommend surveillance for liver cancer in these individuals. Ultrasound imaging and blood tests for alpha fetoprotein performed every six months can flag tumors at an early stage, when the patient has more treatment options. In a study of 1,436 patients with newly diagnosed hepatocellular carcinoma, those who had received these exams had significantly better rates of 3-year survival: 59.1 (surveillance group) versus 29.3 percent (cancer detected incidentally group).

Unfortunately, rates of liver cancer surveillance are low in the United States. A study from the Houston VA Medical Center and Baylor College of Medicine found that less than 20 percent of cirrhosis patients who developed liver cancer had received regular surveillance. Patients with higher income and those who live in urban areas are more likely to receive appropriate exams. Physicians most likely to perform surveillance are gastroenterologists, hepatologists, and those with an academic affiliation.

Cirrhosis itself may have no symptoms in the early stages. Risk factors include excessive alcohol consumption, sexual contact with someone who has hepatitis B or C infection, and contact with blood infected with one of these viruses. Less common causes of cirrhosis are autoimmune hepatitis, hemochromatosis, Wilson's disease, non-alcoholic fatty liver disease, and some medications. Liver function tests should be a part of the annual checkup for most adults, and those with known risks should be especially sure to get their checkups.

References:

1. Davila JA et al, “Use of surveillance for hepatocellular carcinoma among patients with cirrhosis in the United States”, Hepatology. 2010 Jul; 52(1): 132-41.

2. Zapata E et al, “Are hepatocellular carcinoma surveillance programs effective at improving the therapeutic options”, Rev Esp Enferm Dig. 2010 Jul; 102(8): 484-8.

3. Kuo YH et al, “Hepatocellular carcinoma surveillance and appropriate treatment options improve survival for patients with liver cirrhosis”, Eur J Cancer. 2010 Mar; 46(4): 744-51.

4. More about cirrhosis online:
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001301

Linda Fugate is a scientist and writer in Austin, Texas. She has a Ph.D. in Physics and an M.S. in Macromolecular Science and Engineering. Her background includes academic and industrial research in materials science. She currently writes song lyrics and health articles.

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