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Liver Cancer Rates Are Rising; So Is Optimism Around Its Treatment
Nancy S. Reau, MD
Disclosures
November 20, 2020
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In celebration of Medscape's 25th birthday, we are highlighting key breakthroughs that have defined the last quarter century of medicine, as chosen by experts in their respective fields.
Over the past 25 years, cirrhosis and its related complications have undergone a fascinating evolution in the United States. Historically, cirrhosis was driven by viral hepatitis, yet despite curative therapy for hepatitis C and improvements in hepatitis B management, deaths from cirrhosis are expected to triple by 2030. This projection is driven by increasing rates of alcoholic liver disease and nonalcoholic fatty liver disease.
Hepatocellular carcinoma (HCC) is a known consequence of cirrhosis. As the etiologies causing cirrhosis change, liver cancer risk and rates are also evolving. Mortality data from 2000 to 2015 confirm an increase in liver cancer death rates, though hepatitis C virus (HCV) infection now accounts for less than one quarter of these cases.
Comorbid disorders other than cirrhosis add to HCC risk. This was best demonstrated when following individuals with cirrhosis secondary to HCV who had achieved a cure. Male sex, black race, alcohol use, type 2 diabetes, obesity, iron overload, hepatitis B co-infection, and advancing age were associated with the risk of developing liver cancer despite viral eradication.
Even as we have been able to reduce the role of viral hepatitis in liver cancer incidence, the number of people who will be diagnosed with and die of liver cancer continues to rise.
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发表于 2020-11-21 19:37