Make healthier lifestyle choices to combat liver cancer epidemic

Primary liver cancer, also known as hepatocellular carcinoma (HCC), is the fastest growing cause of cancer death in the UK and due to late diagnosis, only 13% with the disease will survive for more than five years – 87% of people surveyed thought the figure was much higher than this. 

In the UK there are around 6,000 cases of primary liver cancer diagnosed each year – around 16 people per day.

Over the past decade, liver cancer has increased by almost two-thirds (63%) in the UK.

Liver cancer is becoming more common at all ages and is now the 9th most common cause of cancer death and has the largest increase in mortality over the past ten years compared to all cancers.

The one-year survival rate for liver cancer is one of the worst cancer survival rates. Only pancreatic cancer patients fare worse.

Most cases of liver cancer in the UK are linked to cirrhosis or advanced liver disease. Risk factors for cirrhosis include harmful drinking of alcohol, being overweight or obese, viral hepatitis, hereditary conditions and primary biliary cholangitis.

Alarmingly, nine in ten people do not realise that gender is a risk factor despite men being twice as likely to be diagnosed with liver cancer in their lifetime.  

The survey of over 2,000 members of the public, conducted throughout October for Liver Cancer Awareness Month, also reveals that: more than half of respondents are unaware that having an underlying liver condition, being overweight or type 2 diabetes can increase their risk of liver cancer; only one in ten people would be ‘extremely concerned’ if they were told there was a problem with their liver; and 42% of people with dietary issues, putting them at risk of liver disease, were not tested or told about liver disease by their GP.

Further reasons for late diagnosis of liver cancer were revealed in a separate liver cancer patient survey, commissioned by the British Liver Trust, which found that one in five patients waited more than six months to get a liver cancer diagnosis after their first visit to a GP. 

Some patients revealed that there were further delays in receiving treatment once they were diagnosed: “There was sometimes a long wait between tests and appointments so it was three months before my first treatment.”

Dr Abid Suddle, Consultant at Kings College Hospital, said: “Lack of awareness of primary liver cancer and its causes is a common problem in the UK which has sadly contributed to the tripling of liver cancer deaths between 1997 to 2016. 

“It is a complex and aggressive disease as most patients have an underlying liver condition so patients need to be treated for the cancer and liver disease. Early diagnosis is vital to provide the best options for treatment.“

Pamela Healy, chief executive at the British Liver Trust, adds: “The lack of awareness among the public and delays experienced by patients should serve as a wake-up call to policy-makers and health providers that more needs to be done to improve early detection.”

The British Liver Trust is also making an urgent plea to the general public to look after their livers. 

“Prevention is always better than cure. More than 80% of people diagnosed with liver cancer have preexisting liver disease,” continues Pamela. “Our nurse-led helpline receives many calls from people who have been diagnosed with liver cancer as an emergency and their preexisting liver disease has never been diagnosed. We need to ensure that every person who is diagnosed with cirrhosis is scanned for liver cancer every six months so that the cancer can be picked up early.

“Taking care of your liver to prevent damage is one the most effective ways you can reduce your risk of cirrhosis, which can lead to liver cancer.”

The British Liver Trust’s Love Your Liver campaign focuses on three simple steps to Love Your Liver back to health: including drinking within recommended limits and having three consecutive days off alcohol every week.

Then you should aim to cut down on sugar, carbohydrates and fat, and take more exercise.

You should also aim to know the risk factors for viral hepatitis and get tested or vaccinated if at risk.

More about liver cancer

Liver cancer is most common in people who already have liver disease, especially if they have cirrhosis. It can also develop in people with no history of liver disease.

Liver cancer often has no symptoms until it is at a late stage. This is why people with cirrhosis are offered regular checks (surveillance) for signs of liver cancer with ultrasound scans and blood tests every six months.

There is a range of different treatments for liver cancer. Some, surgery and liver transplant, aim to remove the cancer completely. But if this isn’t possible you might be offered treatment to shrink the cancer or make it grow more slowly.

The most suitable treatment for you depends on several things including the size and stage of your cancer, how well the rest of your liver is working and how you are generally (performance status). Your specialist will discuss your options with you.

The information on this page is about the most common type of primary liver cancer, hepatocellular carcinoma (HCC or hepatoma). Primary liver cancer is cancer that started in the liver. Cancer that has spread to the live liver from somewhere else in the body is called secondary liver cancer.

Sound the Alarm

Liver disease is a public health emergency. It is diagnosed too late and is the biggest killer of 35 to 49 year olds.

The British Liver Trust believes we need to act now to save lives and this is what underpins its ongoing Sound the Alarm campaign.

It is are calling on the government to implement ten key changes that will directly impact outcomes for patients, ensuring that more people are diagnosed with liver disease or liver cancer at an earlier stage and ensure that improvements are made to the support, specialist care and treatment available to patients following diagnosis. The campaign has been backed by some of the top liver specialists in the UK, including The British Association for the Study of Liver Disease, the British Society of Gastroenterologists and Foundation for Liver Research.

Why now?

The UK is facing a liver disease epidemic and unless we act now more people will die. Since 1970, deaths due to liver disease have increased by an alarming 400%. This is in stark contrast to other major killer diseases, such as heart disease and cancer, in which the number of deaths have either remained stable or decreased. The Covid pandemic has only exacerbated this problem with an increase in liver disease diagnoses with a marked increase in people with diagnosed in hospital.

What’s the problem?

Provision and delivery of liver care services across the UK is variable, and this makes a major contribution to the marked differences in survival. In addition, there is a lack of awareness of the seriousness and prevalence of liver disease together with the stigma that often surrounds it means that it is consistently overlooked, underfunded and under-resourced.

People with liver disease are diagnosed too late and thousands die unnecessarily without access to specialist care.

October is Liver Cancer Awareness Month. Visit britishlivertrust.org.uk/liver-cancer-awareness-month/.