The Rising Threat of Liver Cancer and the Path to Prevention
Liver cancer is becoming a growing global health concern, with alarming projections indicating that its prevalence could nearly double by 2050. However, experts argue that this trend is not inevitable and that significant progress can be made through targeted prevention strategies.
A recent analysis by an expert panel has revealed that three out of five liver cancer cases worldwide are linked to preventable risk factors. These include viral hepatitis, alcohol consumption, and a rapidly increasing issue: obesity-related liver disease. Without urgent intervention, the number of liver cancer cases is expected to rise from 870,000 in 2022 to 1.52 million by 2050, with annual deaths climbing from 760,000 to 1.37 million.
Jian Zhou, a professor at Fudan University and chair of the Lancet commission, emphasized the severity of the situation. “Liver cancer is one of the most challenging cancers to treat, with five-year survival rates ranging from approximately 5 per cent to 30 per cent,” he said. He warned that without immediate action, the number of cases and deaths could nearly double over the next 25 years.
A Changing Landscape of Risk Factors
Traditionally associated with hepatitis infections and heavy alcohol use, liver cancer is now increasingly driven by metabolic dysfunction-associated steatotic liver disease (MASLD), previously known as non-alcoholic fatty liver disease. This condition is prevalent in Europe, affecting up to 25 per cent of the adult population. Beatrice Credi of the European Liver Patients’ Association (ELPA) highlighted the importance of addressing these risk factors. “While these risk factors are common, they are often preventable or manageable with appropriate intervention,” she said, stressing the need for education and public health campaigns.
MASLD is closely linked to obesity and poor metabolic health. Its more severe form, MASH (metabolic dysfunction-associated steatohepatitis), is now the fastest-growing cause of liver cancer globally. As global obesity rates continue to rise, the impact of this condition on liver cancer incidence is expected to grow significantly. The Lancet commission projects that liver cancers linked to MASH will increase by 35 per cent, rising from 8 per cent of cases in 2022 to 11 per cent by 2050.
In high-income countries, where obesity rates are soaring, the situation is particularly concerning. In the United States, MASLD is expected to affect more than half of all adults by 2040, dramatically increasing liver cancer risk. Dr. Hashem El-Serag of Baylor College of Medicine noted that the profile of the disease is evolving. “Liver cancer was once thought to occur mainly in patients with viral hepatitis or alcohol-related liver disease,” he said. However, with the rise in obesity, it is becoming an increasingly prominent risk factor.
The Opportunity for Prevention
Despite the grim projections, the Lancet commission offers hope. It suggests that if new liver cancer cases are reduced by 2 per cent to 5 per cent each year, it could prevent up to 17 million new cases and save as many as 15 million lives by 2050. Achieving this goal would require a multi-pronged global effort, including expanding hepatitis B vaccination and universal adult HBV screening, as well as tackling obesity and alcohol misuse through taxes, warning labels, and better food and beverage policies.
The commission also recommends integrating liver screening into routine care for people with obesity, diabetes, and heart disease, along with investing in public education and early detection tools. Stephen Chan, lead author of the study and a professor at the Chinese University of Hong Kong, emphasized the potential of targeting preventable risk factors. “As three in five cases of liver cancer are linked to preventable risk factors, there is a huge opportunity for countries to target these risk factors, prevent cases of liver cancer, and save lives.”
A Global Call to Action
In Europe, recent policy shifts have focused on prevention and early detection. The European Union’s Beating Cancer Plan aims to achieve 95 per cent coverage for childhood hepatitis B vaccination and screening of pregnant women by 2030. It also encourages healthier lifestyle choices and seeks to reduce exposure to risk factors such as alcohol, tobacco, obesity, and diabetes.
The European Commission has also issued policy recommendations calling for expanded uptake of preventive vaccines, including HPV and hepatitis B, and improved monitoring of vaccine coverage rates. However, Beatrice Credi of ELPA pointed out that industries profiting from alcohol, unhealthy foods, and tobacco play a significant role in driving some of the risk factors for liver cancer. “Our policymakers must prioritise public health,” she said, noting that policies regulating these commercial influences remain weak or inconsistently enforced across the EU.
Beyond Prevention: Improving Care and Support
Prevention alone is not enough. As more people are now living with liver cancer than ever before, the Lancet commission stressed the urgent need for improved care, earlier diagnosis, and better support for patients—especially in regions like Africa and Asia, where the disease burden is highest and healthcare resources are limited.
Valérie Paradis, a professor at Beaujon Hospital in France, suggested that effective prevention could also help ease this burden. “Compared with other cancers, liver cancer is very hard to treat but has more distinct risk factors, which help define specific prevention strategies,” she said. By focusing on these risk factors, countries can make meaningful strides in reducing the impact of liver cancer on global health.
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