Liver Cancer: Incidence and Prevalence

Incidence of Liver Cancer Worldwide: Major Global Concern¹

Incidence and Prevalence

Liver cancer is the sixth most common malignancy worldwide,² with the highest prevalence occurring in southeast Asia and sub-Saharan Africa.³ Hepatocellular carcinoma (HCC) accounts for 80% to 90% of all cases of liver cancer. It is estimated that worldwide, 626,000 patients with HCC are diagnosed every year and it is the third most common cause of cancer-related death.² Most of these patients are males; the male-to-female ratio is approximately approximately 2.4:1.²

Although HCC is not common in developed countries, its incidence has been increasing in Japan, the United States, and western Europe.^4,5 In the United States, HCC ranks as the 20th most common cancer,³ its incidence having increased >70% between 1976 and 1995.⁴ This increase is projected to continue for 20 to 30 years as a long-term consequence of rising rates of hepatitis C virus (HCV) infection.^4,5

Morbidity/Mortality

Hepatocellular carcinoma (HCC), in addition to its high worldwide prevalence, is associated with a high mortality rate - 598,000 deaths annually worldwide.² The median survival time from diagnosis ranges from 20 months in an unselected group of patients⁶ to 6 months in patients who present with advanced disease.⁷ The 5-year relative survival rate for HCC is 7%.⁷

HCC is highly resistant to conventional chemotherapy and is rarely responsive to radiotherapy.⁸ Currently, there is no Food and Drug Administration approved chemotherapy for HCC. More than 80% of patients present with advanced or unresectable HCC, which carries a particularly dismal prognosis.⁹ Furthermore, even patients with resected HCC face a 2-year recurrence rate that can be as high as 50%.⁹

There is a need for effective systemic therapy for HCC as conventional cytotoxic chemotherapeutic approaches have proven to be ineffective.⁵ Identification of the molecular pathways that lead to the uncontrolled proliferation, invasion, and dissemination of disease can aid in the development of more rational and effective treatments for HCC.¹⁰ Targeted agents, such as antiangiogenic agents, apoptosis triggers, and proliferation-signaling inhibitors, are being studied in humans.¹⁰

Read more about:

• Populations at Risk
• RAF Kinase Pathway in HCC
• Commitment of Bayer and Onyx
• Professional Resources

References

1. GLOBOCAN 2002 database. Available at http://www-dep.iarc.fr/.
2. Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clin. 2005;55;74-108.
3. Wilson JF. Liver cancer on the rise. Ann Intern Med. 2005;142:1029-1032.
4. El-Serag HB, Mason AC. Rising incidence of hepatocellular carcinoma in the United States.N Engl J Med. 1999;340:745-750.
5. Thomas MB, Abbruzzese JL. Opportunities for targeted therapies in hepatocellular carcinoma.J Clin Oncol. 2005;23:8093-8108.
6. The Cancer of the Liver Italian Program (CLIP) Investigators. A new prognostic system for hepatocellular carcinoma. A retrospective study of 435 patients. Hepatology. 1998;28:751-755.
7. Llovet JM. Upated treatment approach to hepatocellular carcinoma. J Gastroenterol. 2005;40:225-235.
8. Avila MA, Berasain C, Sangro B, Prieto J. New therapies for hepatocellular carcinoma. Oncogene. 2006;25:3866-3884.
9. Zhu AX. Systemic therapy of advanced hepatocellular carcinoma: how hopeful should we be? Oncologist. 2006;11:790-800.
10. Bruix J, Hessheimer AJ, Forner A, Boix L, Vilana R, Llovet JM. New aspects of diagnosis and therapy of hepatocellular carcinoma. Oncogene. 2006;25:3848-3856.