October is Liver Cancer Awareness Month! This blog will discuss the importance of liver surveillance if you are living with hepatitis B.
Hepatitis B as a Major Risk Factor for Liver Cancer
Although liver cancer is the sixth most common cancer in the world, it is the second most common cause of cancer deaths. Many people do not realize that chronic hepatitis B is the primary global risk factor for developing liver cancer. Certain viruses, including hepatitis B, can cause hepatitis, which translates to “inflammation of liver.” The virus attacks the liver and weakens its ability to perform important tasks like filtering toxins from your blood and maintaining the level of sugar in your blood. Chronic (long-term) infection with hepatitis B or hepatitis C viruses can lead to liver cancer. Worldwide, hepatitis B is very widespread, making it a priority when it comes to the prevention of liver cancer. Approximately 292 million people around the world are living with hepatitis B.
Why Should I be Screened?
Early detection of liver cancer can save lives! Regular screening for liver cancer and early detection are the most effective ways to improve treatment success and survival rates. Early detection of liver cancer results in more treatment options, which greatly improves the chances of survival after initial diagnosis. For patients in whom liver cancer is detected at an early stage and before symptoms occur – while the tumor is small and can be surgically removed – the 5-year survival rate can sometimes be more than 50%. This is why regular liver cancer screening is so important.
If you have cirrhosis or other known risk factors for liver cancer, make sure your health care provider screens you for liver cancer during your medical visits. Finding the cancer early may increase the chance of successful treatment. Your health care provider may refer you to a hepatologist, a doctor who specializes in liver diseases. Hepatologists have the most experience in managing chronic hepatitis B and C infections, including regular screening for liver cancer.
How Often Should I be Screened?
Liver cancer screening can be done as part of your regular visit to the health care provider who manages your hepatitis B. The American Association for the Study of Liver Diseases (AASLD) recommends that liver cancer screening include ultrasound of the liver every 6 months. If you are living with hepatitis B and are not getting screened every 6 months for liver cancer, you should ask your healthcare provider to start!
Listen and Learn!
The Hepatitis B Foundation’s podcast B Heppy has an episode out: Liver Cancer and Hepatitis B. In this episode, they chat with Dr. Kenneth Rothstein of University of Pennsylvania about the relationship between liver cancer and hepatitis B. He gives insight into herbal medicines, treatment options, liver surveillance, and important questions patients should ask their healthcare provider. Listen for more: https://bheppy.buzzsprout.com
October marks the start of Liver Cancer Awareness Month! This month let’s celebrate your liver for all it does for your body!
Action Alert: Urge ACIP to Recommend Universal Hepatitis B Vaccination for Adults in the US
A universal hepatitis B recommendation for adults is critical in addressing the consistently low adult hepatitis B vaccination rates and eliminating viral hepatitis in the United States. Tell the CDC’s Advisory Committee on Immunization Practices (ACIP) that universal adult hepatitis is essential to preventing liver cancer. Take action here.
What Does Your Liver Do?
The liver is such an important organ – it’s like the engine of your body. It does hundreds of vital things to make sure everything runs smoothly:
Stores vitamins, sugar, and iron to help give your body energy
Controls the production and removal of cholesterol
Clears your blood of waste products, drugs, and other poisonous substances
Makes clotting factors to stop excessive bleeding after cuts or injuries
Produces immune factors and removes bacteria from the bloodstream to combat infection
Releases a substance called “bile” to help digest food and absorb important nutrients
The Link Between Liver Cancer and Hepatitis B
The most common type of liver cancer is “primary liver cancer” or hepatocellular carcinoma (HCC). Worldwide, the most common risk factor for primary liver cancer is chronic infection with the hepatitis B virus. Chronic viral hepatitis infections (hepatitis B and hepatitis C) cause about 80% of all liver cancers. Obesity, heavy alcohol use, fatty liver disease (NAFLD or NASH), and some metabolic disorders also increase the risk for primary liver cancer. People chronically infected with hepatitis B are more likely to develop liver cancer than uninfected people because the virus directly and repeatedly attacks the liver. These attacks over time can lead to increased liver damage, cirrhosis (scarring of the liver), and ultimately, liver cancer. People who have chronic hepatitis B can reduce their risk of liver cancer through regular medical monitoring, taking antiviral treatment if necessary, and making healthy lifestyle changes.
The best way to prevent liver cancer is to prevent hepatitis B infection! This is why hepatitis B vaccination is so important. When someone gets vaccinated to protect them from getting hepatitis B, they are also preventing liver cancer!
How Would I Know if I Have Liver Cancer?
If you have chronic hepatitis B, make sure you are getting routine surveillance for liver cancer every 6 months with your healthcare provider. This surveillance, which includes a combination of blood tests and liver imaging (ultrasound) is so important because early detection of liver cancer greatly improves the chances of survival with treatment. For patients in whom liver cancer is detected at an early stage and before symptoms occur – while the tumor is small and can be removed – the 5-year survival is greatly improved. Learn more about who should be screened for liver cancer here.
Unfortunately, liver cancer is on the rise in the United States. The 2020 Annual Report to the Nation on the Status of Cancer found that the incidence of primary liver cancer in the United States increased by 2.5% overall and by 3.7% amongst women – the largest increase in incidence of any cancer between 2012-2016. Liver cancer was also stated as the second most common cause of death for Asian American and Pacific Islander males, who are disproportionately impacted by HBV, and the fifth most common cause of cancer deaths for men overall.
Making sure that people are protected from getting hepatitis B is so important in the U.S. – and establishing universal vaccination recommendations is essential to reducing liver cancer incidence and mortality.
The Role of Universal Screening Guidelines for Hepatitis B
In the U.S., current childhood immunization recommendations by the Advisory Committee on Immunization Practices (ACIP) were established in the 1990s, and have significantly helped reduce rates of hepatitis B transmission over the past two decades, as more and more children have been vaccinated against hepatitis B. Individuals born prior to these recommendations, however, may be vulnerable to HBV, and span three generations: Baby Boomers, Generation X, and Millennials. Together, these groups account for approximately 63% of the U.S. population. Within this vulnerable population, the recent rise in incidence of hepatitis B cases has increased the most within 30- 49 year olds, attributed to the opioid epidemic. Of the 2.4 million Americans estimated to be living with hepatitis B, approximately 75% remain undiagnosed and may display no symptoms. This increases the risk of transmission to unvaccinated household members or sexual partners who are unaware that precautions should be taken to prevent transmission. Lack of awareness and low vaccination rates in this community leave millions of Baby Boomers, Generation X, and Millenials vulnerable to HBV.
Take Action: Sign the Petition to Support a Recommendation for Hepatitis B Vaccination for All Adults!
The CDC’s Advisory Committee on Immunization Practices (ACIP) is currently reviewing evidence to determine if they should recommend universal adult hepatitis B vaccination. If the committee votes in favor of the proposal, this would mean that all adults in the United States would officially be recommended to receive the hepatitis B vaccine by the federal government.
Listen and Learn – Listen to B Heppy’s newest podcast episode “Liver Cancer and Hepatitis B”! We chat with Dr. Rothstein from the University of Pennsylvania about the relationship between hepatitis B and liver cancer. He offers provider insight and recommendations to individuals listening.
Check Out Liver Cancer Connect – This program was created to provide individuals and families with the information and support they need when facing the challenge of primary liver cancer.
Seek Community Support – Hep B Community a global peer-led, volunteer-driven forum to support those living with and affected by hep B. They are dedicated to connecting people affected by hepatitis B with each other and verified experts in the field, who provide trustworthy and accurate advice.
Learn More From Experts – Dr. Robert Gish talks about treatment options for liver cancer. How does the stage of cancer affect treatment? Why are screening and surveillance so important? What are the available treatments and what are the therapies in development? Find out by listening to the webinar.