Prevention and screening
“More than half of the liver cancers are avoidable”
A study corroborates what specialists observe everywhere: cases are increasing. Interview with Antonia Digklia from the CHUV medical oncology service.
Illustration Pretext. Overweight, obesity and type 2 diabetes are part of risk factors to develop liver cancer.
IMAGO/HalfPoint Images
- Experts provide a doubling of liver cancers by 2050.
- Obesity and diabetes considerably increase the risk of liver cancer.
- Men are more affected because they neglect their health more.
- Hepatitis B vaccination is part of the prevention measures against this disease.
In a study published at the end of July, experts from the “The Lancet” commission, a reference British scientific review, launch the alert: the number of liver cancers explodes. According to their projections, hepatocellular carcinomas could almost double by 2050from 870,000 in 2022 to 1.5 million.
Globally, this type of cancer is the most frequent sixth, and the third that kills the most. While in 60% of cases it is avoidable, the study recalls. The development of liver cancer characterized by a progression ranging from a chronic liver disease to cirrhosis and then to cancer, this extended period offers an opportunity for intervention to prevent the disease from manifesting itself.
To slow down the progress of the crab, a special effort must be placed on prevention. Experts from the “The Lancet” commission offer a number of recommendations. As strengthened and vaccination against hepatitis B (which can precede liver cancer), raise awareness of alcohol dangers or promote regular activity and healthy diet.
Doctorate Antonia Digklia is a doctor associated with the CHUV medical oncology service. She returns to the key points of the study.
Doctorate Antonia Digklia is a doctor associated with the CHUV medical oncology service.
DR
What did you think of the study published in “The Lancet”?
It confirms what we see in recent years in our clinical practice: the number of liver cancers is increasing. While, as the study also recalls, a certain number of risk factors are well known and avoidable. But that not much is implemented in Switzerland, especially in matters of public health policy, to target this problem.
At CHUV, what are the figures that testify to this increase?
We do not take specific statistics, but what we see at the clinical level is an increase in cirrhotic patients whose liver cancer is not linked to alcohol consumption but is characterized by an accumulation of fats in the liver, associated with metabolic disorders like obesity (a body mass index of more than 30)diabetes or dyslipidemia (an anomaly of the lipid assessment).
How can these cancers be avoided? By a targeted public health policy, as you mention it?
An effective public health policy should, in my opinion, focus on better awareness of the population of this problem. Men, in particular, are more affected than women and should therefore be targeted as a priority. They do not realize the effects of their alcohol consumption on their health. They imagine that only deep alcoholics are affected. While regular, daily consumption is an important risk factor. Overweight people also seem to ignore that obesity and type 2 diabetes are part of risk factors to develop liver cancer. Here again, we should better educate these people.
Why are men more affected than women?
Men tend to trivialize their alcohol consumption, they pay less attention to their image, and society stigmatizes their overweight. While women are generally much more concerned about their appearance, not to gain weight. In general, men take less care of them and go less often to the doctor.
The liver has a particularity: it does not make noise. What does that mean?
I often say that it is a “feminine” organ because it suffers in silence. If you have a heart problem, or a problem with the lungs, you will quickly see signs. You will cough, for example. But for the liver, when the symptoms appear, it is often already too late. Even a blood test does not always identify the problems. Patients often tell us: they do not understand, they regularly do blood checks that did not show anything special. Hence the importance of prevention.
And screening. What are the brakes that prevent patients from being tested?
What we see, in general, is that adults who are healthy will rarely see their doctor. They are starting to consult at their fifties when symptoms appear. However for a good part of these patients, if we could have seen them before the disease declares itself, it would have been time to act upstream and avoid the development of pathology. For example, he could have vaccinated them against hepatitis B (which reduces the risks of developing liver cancer), if they were not already. Or remind them of the importance of a healthy lifestyle to fight against this type of cancer. This is what the screening should serve. But for that it is necessary once again to raise awareness of the population. This is what we managed to do for women and breast cancer. This is because we hammered the importance of detecting him as soon as they used to regularly be examined.
What are the advice on prevention to follow?
The prevention of liver cancer is mainly based on vaccination against hepatitis B and the reduction of risk factors linked to hepatitis C and alcohol consumption. Overweight and diabetes can increase the risk of non -alcoholic liver basic (Editor’s note: Masld, formerly known as “foie gras”)which is a risk factor in liver cancer. Healthy lifestyle, including a balanced diet and regular physical activity, can also help reduce risks. In addition, regular screening – by blood test and ultrasound in order to monitor the state of the liver – is recommended for people at risk, such as chronic carriers of hepatitis B or C.
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