Global burden of liver cancer could rise by more than 55% by 2040, analysis reveals

A new analysis reveals that primary liver cancer was among the top three causes of cancer death in 46 countries in 2020 and the number of people diagnosed with or dying from primary liver cancer per year could rise by more than 55% by 2040. Investigators call for efforts to control the disease to be prioritized in a new study in the Journal of Hepatology, published by Elsevier.

Liver cancer causes a huge burden of disease globally each year. It is also largely preventable if control efforts are prioritized — major risk factors include hepatitis B virus, hepatitis C virus, alcohol consumption, excess body weight, and metabolic conditions including type 2 diabetes."

Isabelle Soerjomataram, MD, PhD, Senior Author, International Agency for Research on Cancer (IARC/WHO), Cancer Surveillance Branch, Lyon, France

"In light of the availability of new and improved global cancer incidence and mortality estimates, we wanted to provide the most up-to-date assessment of the burden of liver cancer and develop an essential tool for national liver cancer control planning," explained lead author Harriet Rumgay, PhD candidate, International Agency for Research on Cancer (IARC/WHO), Cancer Surveillance Branch, Lyon, France. "In this analysis we describe where liver cancer ranks among all cancer types for cancer diagnoses and deaths in nations across the world. We also present predictions of the future liver cancer burden to 2040."

Investigators extracted data on primary liver cancer cases and deaths from the International Agency for Research on Cancer's GLOBOCAN 2020 database, which produces cancer incidence and mortality estimates for 36 cancer types in 185 countries worldwide. The predicted change in the number of cancer cases or deaths by the year 2040 was estimated using population projections produced by the United Nations.

Results showed that in 2020, an estimated 905,700 individuals were diagnosed with liver cancer and 830,200 died from liver cancer globally. According to these data, liver cancer is now among the top three causes of cancer death in 46 countries and is among the top five causes of cancer death in nearly 100 countries including several high-income countries.

Liver cancer incidence and mortality rates were highest in Eastern Asia, Northern Africa, and South-Eastern Asia. Investigators predict the annual number of new cases and deaths from liver cancer will rise by more than 55% over the next 20 years, assuming current rates do not change. The predicted rise in cases will increase the need for resources to manage care of liver cancer patients.

The researchers were alarmed to find that the number of cases and deaths from liver cancer will continue to increase year on year. They caution that in order to avoid this rise in cases and deaths, countries across the world must achieve at least a 3% annual decrease in liver cancer incidence and mortality rates through preventive measures.

These estimates provide a snapshot of the global burden of liver cancer and demonstrate the importance of improving and reinforcing liver cancer prevention measures.

"We are at a turning point in liver cancer prevention as successes in hepatitis B virus and hepatitis C virus control efforts will be reflected in rates of liver cancer in the next few decades," noted Dr. Soerjomataram. "These efforts must be sustained and reinforced especially considering the disruption caused by the COVID-19 pandemic on certain hepatitis B and C virus control efforts."

The authors call for public health officials to prepare for the predicted increase in demand for resources to manage the care of liver cancer patients throughout the cancer pathway, including improved access to palliative care due to the predicted growing number of liver cancer patients, and to reinforce current liver cancer prevention measures such as immunization, testing, and treatment for hepatitis B virus; population-wide testing and treatment for hepatitis C virus infection; reduction of population alcohol consumption; and curbing the rise in diabetes and obesity prevalence.

"The number of people diagnosed with or dying from liver cancer per year could increase by nearly 500,000 cases or deaths by 2040 unless we achieve a substantial decrease in liver cancer rates through primary prevention," concluded Dr. Soerjomataram.