As Liver Cancer Rates, Mortality Continue to Rise, Advocacy and Policy Efforts Are Important

During a session at the 20th Annual Meeting of the International Society of Gastrointestinal Oncology®, Sarah Manes, liver cancers program director at the Global Liver Institute, highlighted the unmet needs related to liver cancer and discussed the organization’s mission to advance research and address health disparities.

Liver cancer is the sixth most common cancer and the third deadliest cancer in the world. “There are not many cancers right now that are staying stagnant,” Ms. Manes noted. “Most of the cancers in terms of incidence rate and morbidity/mortality are decreasing or at the very least stabilizing. Liver cancer is one of the very few cancers [where] that incidence rate is steadily increasing, and the mortality rate is even more steadily increasing.”

The World Health Organization estimates that by 2040, there will be 1.4 million new liver cancer cases and 1.3 million liver cancer deaths annually. Men aged 65 years and older have the highest rate of liver cancer, and Hispanic individuals have the highest liver cancer incidence. In addition, 70% of liver cancer cases are preventable with available knowledge and technology. “We truly have a great obligation and ability to be able to curb those numbers,” according to Ms. Manes.

The greatest risk factors for hepatocellular carcinoma are:

• Hepatitis B (44.0%)
• Alcohol (26.0%)
• Hepatitis C (21.0%)
• Smoking (13.0%)
• Obesity (9.0%)
• Diabetes (7.0%)
• Aflatoxin (4.6%-28.2%)

The Global Liver Institute, a patient advocacy and policy organization, is looking to:

• Transform the culture by decreasing stigma and increasing share of voice for liver health
• Improve liver health and patient outcomes by redesigning health systems
• Advance policy by positioning liver issues on the global public health agenda with legislative, regulatory, and reimbursement frameworks

The organization is “committed” to doubling the 5-year survival rate for liver cancer in the United States by:

• Increasing the number of patients with liver cancer diagnosed at an early stage
• Supporting knowledge, choice, and access to appropriate treatment options
• Reducing disparities in diagnosis and treatment access
• Advancing policy and advocacy to support research, access, and information for those impacted by liver cancer

Ms. Manes then discussed disparities related to liver cancer and highlighted the continued need for advocacy, research, and awareness and education. She noted that 60% of uninsured individuals do not get screening and prevention services. “What does that do to build up and put pressure on our health care system, and how does that intersect with disparities and health equity?” she asked. Ms. Manes noted that research should be more targeted to represent a more diverse population, as clinical trial populations often do not always represent the general patient population. She advocated for policy work and funding to expand Medicare and Medicaid to advance the goal of health equity. For awareness, she highlighted the #OctoberIs4Livers campaign to shine a light on October being Liver Cancer Awareness Month.

Ms. Manes concluded by discussing the importance of a multidisciplinary team to deliver person-centered care, including:

• Early screening
• Solving for fragmentation of referral source
• Holistic goal setting/treatment decision-making
• Clinical trial information
• Personalized/modularized patient education
• Emotional and social support/peer mentorship
• Working with a multidisciplinary care team
• Second opinions
• Managing the cost of care and cancer-related financial toxicity
• Transportation
• Physical activity
• Nutrition

The Global Liver Institute is committed to creating resources for patients and families in a variety of languages. “We have to be committed to far more than just providing written resources in different languages. How do we work with learning styles? How do we work with rural, both North America- and US-based and on a global basis, what does that look like for rural access?” she concluded.

Learn more about the Global Liver Institute.