Three in five liver cancer cases are preventable if key risk factors such as alcohol consumption, fatty liver disease, and viral hepatitis B and C are addressed, according to a new analysis by The Lancet Commission on Liver Cancer published on Monday.
The Commission warns of a growing global health crisis, highlighting that liver cancer is now the sixth most common cancer and the third leading cause of cancer-related deaths worldwide.
A major concern is the increasing prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) — formerly known as non-alcoholic fatty liver disease. It affects an estimated one-third of the global population. MASLD occurs when fat accumulates in the liver, and while it is preventable through a healthy diet, physical activity, and weight loss, its rising trend is fueling new cancer cases. A more severe form of the disease, metabolic dysfunction-associated steatohepatitis (MASH), is now the fastest-growing cause of liver cancer globally.
According to the Commission, the number of new liver cancer cases could nearly double from 870,000 in 2022 to 1.52 million in 2050, with deaths rising from 760,000 to 1.37 million during the same period. The steepest increases are expected in Africa, driven largely by population growth and ageing.
Prof Jian Zhou at Fudan University in China, who led the research, said, “liver cancer is a growing health issue around the world. It is one of the most challenging cancers to treat, with five-year survival rates ranging from approximately 5% to 30%. We risk seeing close to a doubling of cases and deaths from liver cancer over the next quarter of a century without urgent action to reverse this trend.”
The analysis shows shifting causes of liver cancer. In 2022, 39% of liver cancer cases were linked to hepatitis B virus (HBV), 29% to hepatitis C virus (HCV), 19% to alcohol, and 8% to MASH. By 2050, MASH-related cases are projected to rise to 11%, and alcohol-linked cases to 21%, while HBV and HCV-related cases are expected to decline slightly to 37% and 26%, respectively.
“As three in five cases of liver cancer are linked to preventable risk factors, mostly viral hepatitis, alcohol and obesity, there is a huge opportunity for countries to target these risk factors, prevent cases of liver cancer and save lives,” said the first author, Stephen Chan, of the Chinese University of Hong Kong.
The commission author Prof Hashem B El-Serag of Baylor College of Medicine in the US said, “Rising obesity rates are now a major driver of liver cancer, beyond viral hepatitis and alcohol.”
