LIVER CANCER: Hepatitis C Infections Cause Surge in Carcinoma
The incidence of liver cancer has increased significantly over the past two decades, with hepatitis C the likely cause, according to a report in this week's New England Journal of Medicine. Researchers from the Veterans Affairs Medical Center and the University of New Mexico found that the number of cases of liver cancer increased from 1.4 per 100,000 people between 1976 and 1980 to 2.4 per 100,000 between 1991 and 1995, with the cancer more than twice as common in black men than in white men (El-Serag/Mason, NEJM, 3/11 issue). The American Cancer Society's Michael Thun said, "This is one of several lethal tips of the iceberg of the chronic hepatitis epidemic," caused in part by hepatitis C-tainted blood transfusions before reliable screening procedures were developed in the early 1990s.
A Big Problem
Four million Americans are estimated to be infected with hepatitis C, 1% to 5% of whom will develop liver cancer. New infections "dropped to about 36,000 in 1996" thanks to blood screening and a decrease in IV-drug use, according to the CDC. Study co-author Hashem El-Serag of the VA said, "I think (the rise in liver cancer) will probably continue for a decade or more. If any of the projections are correct, we haven't seen a lot of the cases yet" (Brown, Washington Post, 3/11). Hepatocellular carcinoma, the type of liver cancer measured in the NEJM study and by far the most common type, "is almost always fatal," with 5% of patients surviving five years after it is diagnosed (AP/New York Times, 3/11).