In the battle against cancer, Canada is making progress. Lung cancer is down, thanks to a dropping smoking rate, and breast cancer is killing fewer women, due to better screening and treatments. But liver cancer is a different story. While still rare at approximately 2,000 new cases each year, it’s one of the fastest rising cancers in the country.
The biggest risk factor for liver cancer is a chronic hepatitis B or C infection. The hepatitis B virus (HBV) can be transmitted through blood, semen, vaginal fluids or saliva; hepatitis C (HCV) is spread by blood-to-blood contact. About 600,000 Canadians are infected with one of these viruses, and many are unaware of their condition.
As a general rule, hepatitis infections aren’t a great source of worry for Canadians. The symptoms are often minor or non-existent, and in many cases they clear up without treatment. However, some people’s immune systems don’t succeed in fighting off hepatitis. Unless these “chronic carriers” get treated, they become higher-risk targets for liver cancer. HBV and HCV inflame the liver, which can lead to advanced scarring-known as cirrhosis. When the liver sets out to repair these scars, it begins regenerating cells; more regenerated cells means a greater chance that one of them might mutate and cause cancer.
Because primary liver cancer doesn’t usually show symptoms until it’s too late for effective treatment, it has an abysmal survival rate. Only one in five people diagnosed with it will survive for the next five years.
To prevent liver cancer, the Centers for Disease Control and Prevention has urged all American baby boomers to get a hepatitis C blood test. Although the Canadian Liver Foundation has pushed for a similar screening strategy, our national approach is to focus on testing higher-risk groups. These include people who have travelled or lived in parts of the world where hepatitis is more common; injection drug users; blood-transfusion recipients before July 1990; people with tattoos; people who have unprotected sex with multiple partners; and the housemates of infected people.
An HBV vaccine was introduced for Canadian children in the 1990s. There is no HCV vaccine, but researchers hope to develop one. Until then, let’s roll up our sleeves for testing and add a decreasing liver cancer rate to our list of wins.
If you do test positive for hepatitis, don’t panic. Catching, treating and monitoring it reduces your chances of complications, including liver cancer. The outcome percentages shown here include patients who do not treat their hepatitis.
Another leading risk factor for liver cancer is heavy alcohol consumption, because like hepatitis, it scars the liver tissue. Heavy drinking, defined as having five or more drinks on
a single occasion, is relatively common among Canadians.