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Liver cancer and its prevention
Hideaki Tsukuma1, Hideo Tanaka, Wakiko Ajiki
1Department of Cancer Control and Statistics, Osaka Medical Center for Cancer and Cardiovascular Diseases, 3-3 Nakamichi 1-chome, Higashinari-ku, Osaka 537-8511, Japan. tukuma-hi@mc.pref.osaka.jp
Asian Pacific Journal of Cancer Prevention : APJCP
|October 21, 2005
Summary
Hepatitis C virus (HCV) infection significantly increases liver cancer risk in Japan, particularly for those born between 1931-1935. Interferon therapy shows promise in reducing hepatocellular carcinoma (HCC) risk, though screening effectiveness remains debated.
Area of Science:
- Hepatology
- Epidemiology
- Oncology
Background:
- Liver cancer is a major cause of cancer mortality in Asia and Africa.
- Japan's liver cancer epidemiology is distinct, with hepatitis C virus (HCV) being the primary etiological factor, unlike hepatitis B virus (HBV) in other regions.
Purpose of the Study:
- To review the descriptive epidemiology and prevention of liver cancer in Japan.
- To present Japanese experiences and epidemiological studies on liver cancer occurrence.
- To describe national projects targeting hepatitis and liver cancer in Japan.
Main Methods:
- Analysis of distinctive time-trends in liver cancer incidence by birth cohort and age.
- Follow-up studies on chronic hepatitis C patients and HCV carriers to assess hepatocellular carcinoma (HCC) risk.
- Retrospective cohort studies evaluating interferon (IFN) therapy efficacy.
- Evaluation of periodic screening programs (ultrasonography, alpha-fetoprotein) for early HCC detection.
Main Results:
- Liver cancer incidence peaked in Japanese birth cohorts around 1931-1935, linked to endemic HCV infection.
- HCV carriers face an increased risk of HCC, with cumulative risks estimated at 21.6% for males and 8.7% for females (ages 40-74).
- Interferon (IFN) therapy, with or without ribavirin, demonstrated effectiveness in reducing HCC risk among chronic hepatitis C patients.
- Periodic screening for early HCC detection did not show a significant benefit in reducing mortality in a non-randomized controlled study.
Conclusions:
- HCV infection is a critical determinant of liver cancer in Japan, with specific birth cohorts exhibiting high incidence.
- Interferon-based therapies offer a viable strategy for mitigating HCC risk in HCV-infected individuals.
- National projects aim to control liver cancer in HCV-endemic countries through targeted screening and treatment, though screening recommendations vary globally.