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Should I Be Screened for Liver Cancer?

Liver cancer and hep C

Hepatitis C can cause inflammation and scarring of the liver, such as fibrosis and cirrhosis. If hepatitis C is left untreated and continues to do damage to the liver, it can increase the chances of liver cancer.

Liver cancer, also known as hepatocellular carcinoma (HCC), is the third leading cause of cancer death in the world, although it is not very common in the United States.1 In 2015, there were approximately 71,990 people living with liver cancer in the US. In 2018, there will be more than 42,000 new cases of liver cancer.2

What are symptoms of liver cancer?

While symptoms can present differently for different people, some common symptoms of liver cancer include3:

  • A hard lump on the right side of the abdomen
  • Pain or discomfort in the right side of the abdomen
  • Swelling of the abdomen
  • Jaundice, or yellowing of the skin or whites of the eyes
  • Fatigue or tiredness
  • Nausea and vomiting
  • Loss of appetite or a feeling of fullness after a small meal
  • Weight loss without trying

Rates on the rise

Over the last 10 years, rates for new cases of liver cancer have been rising, on average, 2.6% each year.2

Recent research shows that the liver cancer death rates have also been on the rise. For adults over the age of 25, the age-adjusted liver cancer death rate increased 43% from 2000 through 2016.4 Death rates for liver cancer varied by age, but were highest for adults over the age of 65.4

Increasing rates of hepatitis C, as well as other forms of viral hepatitis, are one factor leading to the increased number of liver cancer diagnoses and deaths.

What tests are used to check for liver cancer?

Liver cancer screening is used to check for signs of liver cancer before there are any symptoms. Your doctor may suggest screening if you have risk factors, such as hepatitis C. Although there is no standard screening test for liver cancer, doctors will use imaging tests, such as ultrasounds, CT scans, or MRI scans, to screen for liver cancer. Blood tests, such as a comprehensive metabolic panel (CMP), liver function tests, or tests for a tumor marker, Alpha-fetoprotein (AFP), may also be used.5 If any tests come back abnormal or show signs of liver cancer, a biopsy may be done. A biopsy involves removing a small piece of the liver and looking at the cells under a microscope to check for signs of cancer.

How often should I be screened?

If you have hepatitis C and you’re concerned about your risk for liver cancer, you should talk to your doctor about screening. You and your healthcare team will make a plan for how often you should be checked for liver cancer.

It is important to note that curing hepatitis C is associated with a 75% reduction in risk of liver cancer.6 Other lifestyles changes, such as a healthy diet and limited alcohol intake, can also help to prevent risk of cancer, including liver cancer.

View References
  1. General Information About Liver (Hepatocellular) Cancer. National Cancer Institute. Available at: https://www.cancer.gov/types/liver/patient/liver-prevention-pdq#section/_21
  2. Cancer Stat Facts: Liver and Intrahepatic Bile Duct Cancer. National Cancer Institute. Surveillance Research Program (SRP). Available at: https://seer.cancer.gov/statfacts/html/livibd.html
  3. Adult Liver Cancer Symptoms, Tests, Prognosis, and Stages (PDQ®)–Patient Version. National Cancer Institute. Available at: https://www.cancer.gov/types/liver/patient/about-adult-liver-cancer-pdq
  4. Xu JQ. Trends in liver cancer mortality among adults aged 25 and over in the United States, 2000–2016. NCHS Data Brief, no 314. Hyattsville, MD: National Center for Health Statistics. 2018. Available at: https://www.cdc.gov/nchs/products/databriefs/db314.htm
  5. Liver (Hepatocellular) Cancer Screening. National Cancer Institute. Available at: https://www.cancer.gov/types/liver/patient/liver-screening-pdq#section/_20
  6. Liver Cancer and Viral Hepatitis. Centers for Disease Control and Prevention (CDC). Available at: https://www.cdc.gov/hepatitis/featuredtopics/livercancerandhepatitis.htm

Comments

View Comments (1)
  • Susan Simon moderator
    4 months ago

    It is patients with late stage disease (cirrhosis) who should be screened after cure. An AFP test, along with imaging, should be routine every 6 months. When cure is reached, it is still important to continue screening for HCC, although the risk is lower than before treatment.

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