Hepatocellular Carcinoma

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Hepatocellular Carcinoma

Hepatocellular Carcinoma -- United States, 2001-2006

How can hepatocellular carcinoma (HCC), often caused by hepatitis B and C, be prevented? This report outlines new data on the disease, and ways that it can be prevented through vaccines and education.Morbidity & Mortality Weekly Report, July 2010

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Editors Note:

This report provides the most recent population-based estimates of HCC incidence rates and trends in the United States and the first state-specific HCC trends. The findings indicate continued increases in HCC incidence, consistent with earlier reports using different methodology.[2,4] However, requiring microscopic confirmation of HCC likely produced more conservative incidence rate estimates than analyses of NPCR/SEER data published previously.[2,4]

,Chronic HBV and HCV infections that persist for decades are major risk factors for HCC. Both infections cause chronic inflammation that can progress to fibrosis, cirrhosis, and eventually malignancy.[3]

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HBV infection also can be directly oncogenic.[3] In addition, alcohol consumption, steatohepatitis, and type II diabetes have been linked to HCC;[2] these risk factors for HCC amplify the effects of viral hepatitis but also might cause HCC in the absence of viral hepatitis.[2]The age and race profile of persons with HCC reflects the demographic characteristics of persons with chronic viral hepatitis. During 2001–2006, HCC incidence was highest among Asians/Pacific Islanders, Hispanics (compared with non-Hispanics), blacks, persons aged ≥50 years, and males. The largest increases occurred among whites, blacks, persons aged 50–59 years, and males. Rates were highest among

persons born during 1946–1964 (who are now aged 46–64 years), particularly black males.[3,4] In the absence of testing and care, the risk for HCC is expected to increase with aging of the cohort of persons with HCV infection.[5]Asians/Pacific Islanders, black adult males, and persons living in the United States who were born in regions where HBV is endemic (e.g., Asia and sub-Saharan Africa) have high rates of both HBV infection and HCC (2,5–8). As shown in this analysis, the rate of HCC did not increase among Asians/Pacific Islanders during 2001–2006. Some reasons for this might be early implementation of hepatitis B vaccination programs, changes in immigration patterns, and the impact of hepatitis B therapy on disease progression.[3,4]The findings in this report are subject to at least three limitations. First, misclassification of race and ethnicity in the registries and multiracial status of patients might underestimate HCC rates in certain populations. Second, although some states collect information on specific Asian subgroups, these data are not available at the national level; published reports from selected geographic areas suggest that certain ethnic Asian/Pacific Islander subgroups have greater risk for HCC than other Asian/Pacific Islander subgroups.[3] Finally, cancer registries do not routinely collect information on etiologic factors for HCC, including chronic viral hepatitis.Most cases of HCC are preventable. Prevention of HBV and HCV transmission and progression of chronic viral disease leads to

declines in HCC incidence.[9] However, new HBV and HCV infections continue to occur.[6,7] Populations at greatest risk for new infection include children born to HBV-infected mothers and adults with sexual and drug use risk behaviors. Of the estimated 3.8–5.3 million persons living with chronic viral hepatitis in the United States, most are unaware of their infection.[5] Early identification of viral hepatitis with referral to prevention and care services can decrease transmission to others. Treatment of viral hepatitis is cost-effective, and medical management can decrease morbidity.[10]In a recent report on

prevention of hepatitis and liver cancer, the Institute of Medicine (IOM) called for a national comprehensive approach comprised of interventions to prevent HBV and HCV transmission and interventions to reduce the morbidity associated with chronic HBV and HCV infections.[5] IOM recommends improved viral hepatitis surveillance, community education to address health disparities, support for vaccine-based strategies to eliminate HBV transmission, and development of prevention and health services that target key populations (i.e., drug users, foreign-born persons, and persons infected with human immunodeficiency virus), including screening for HBV and HCV infections linked to appropriate medical management.

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Response Of Hepatocellular Carcinoma To Chemoembolization May Be Predicted By Functional MRI09 July 2010Early knowledge of hepatocellular carcinoma (HCC) response to transcatheter arterial chemoembolization (TACE) is crucial for determining treatment success, timing of repeat treatment, and patient prognosis

Bayer’s Liver Cancer Drug to Be Tested Against Sirtex

Bayer AG’s Nexavar treatment for advanced liver cancer will be tested against a radiotherapy made by Sirtex Medical Ltd. in a final-stage study of patients in the Asia-Pacific region.A total of 360 patients with inoperable liver cancer in 13 countries will receive either Nexavar or Sydney-based Sirtex’s SIR-Spheres, Singapore’s National Cancer Centre, the trial organizer, said in an e-mailed statement today.

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