3 in 5 liver cancer cases due to preventable risk factors, obesity-linked cases spiralling, says Lancet study: Why our lifestyle matters even more
Researchers have predicted that the share of liver cancer cases caused by a severe form of fatty liver called metabolic dysfunction-associated steatohepatitis (MASH) will increase by 35 per cent (8 per cent to 11 per cent) by 2050. They have further predicted that if countries can reduce the incidence of liver cancer cases by 2 to 5 per cent each year by 2050, they could prevent nine to 17 million new cases of liver cancer and save eight to 15 million lives.
Stephen Lam Chan from the Department of Clinical Oncology, University of Hong Kong, and other authors of the Commission have called for increased public, medical and political awareness about high-risk groups, including individuals with diabetes and obesity.
Current liver cancer burden in India
Dr Sheetal Dhadphale, Director, Hepatology and Transplant Medicine, Sahyadri Hospitals, Pune, said that the current incidence of liver cancer ranges from 2.15 to 2.27 per lakh of population while the mortality is 2.21 per lakh. 'Liver cancers due to Hepatitis B are slightly decreasing but those related to alcohol and MASLD are increasing. Awareness campaigns and focussed treatments are necessary to combat this spiral,' she explained.
Liver cancer is amongst the fastest growing cancers, said Dr Shiv Kumar Sarin, founding director, Institute of Liver and Biliary Sciences (ILBS), New Delhi. He flagged concern over the rise in the number of people living with obesity, diabetes and fatty liver disease. 'Studies have shown that for 100 cases of liver cancer, 35 to 40 are among those with diabetes and fatty liver disease,' he said.
What about liver screening?
Lancet authors advocate screening for liver damage into routine healthcare practice for patients in the high risk group. 'Healthcare professionals should also integrate lifestyle counselling into routine care to support patients to transition to a healthy diet and regular physical activity. Furthermore, policy makers must promote a healthy food environment via policies such as sugar taxes and clear labelling on products with high fat, salt, and/or sugar,' they said.
Why public health policies need to target obesity, alcohol consumption
Liver cancer is already a major cause of death and disability. Globally, it's the sixth most common cancer and the third leading cause of death from cancer. Chair of the Commission, Prof Jian Zhou, Fudan University (China) said, '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. We risk seeing close to a doubling of cases and deaths from liver cancer over the next quarter of a century without urgent action to reverse this trend.' According to Prof Chan, Chinese University of Hong Kong (Hong Kong, China), 'As three in five cases of liver cancer are linked to preventable risk factors, mostly viral hepatitis, alcohol and obesity, there is a huge opportunity for countries to target these risk factors, prevent cases of liver cancer and save lives.'
How to reduce risk factors
The commission highlights several ways to reduce these risk factors, including increasing the coverage of the hepatitis B vaccine and public health policies targeting obesity and alcohol consumption. It even urges governments to intensify efforts for increasing HBV vaccination — such as vaccine mandates in high-prevalence countries — and implement universal HBV screening for adults 18+, alongside targeted HCV screening in high-risk areas. Policy makers should enact minimum alcohol unit pricing, warning labels and advertisement restrictions for alcoholic beverages.
Anuradha Mascarenhas is a journalist with The Indian Express and is based in Pune. A senior editor, Anuradha writes on health, research developments in the field of science and environment and takes keen interest in covering women's issues. With a career spanning over 25 years, Anuradha has also led teams and often coordinated the edition.
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Indian Express
5 hours ago
- Indian Express
Commission orders Mohali hospital and doctor to pay Rs 50 lakh compensation for medical negligence
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However, he was kept in the ICU on the pretext that his ascites was to be removed from the stomach,' the complainant stated. The complainant alleged, 'On July 28 and 30, 2021, tapping was done, and due to negligent tapping, his oxygen level came down drastically, and he was put on oxygen support. There was panic among doctors, as Harit was fully conscious despite the oxygen mask, and he heard the conversation the Director of the hospital had during his visit that 'tapping was wrongly done upon him and it would be done again'.' 'When I went to meet my husband during the visiting hours the next day, he was unable to speak due to the mask on his mouth, but by making gestures, he asked me for a pen and paper as he wanted to write something that he could not convey verbally. He wrote a note, 'Subah Director had come; Director said Chabra has done something wrong tapping, and it will be done again',' Priyanka alleged. The complainants alleged that due to wrong tapping, oxygen parameters of Harit 'dropped drastically and he was put on oxygen'. Priyanka stated, 'On the morning of August 1, 2021, she received a call from the ICU Unit on her mobile that Harit's condition had deteriorated and he was not responding to the treatment, so he needed to be put on a ventilator, for which the consent was sought. I gave my consent.' 'The ventilator had to be put on Harit due to an abdominal ascetic tap. The doctor concerned negligently ruptured the diaphragm, leading to hydrothorax, which further led to acute respiratory failure. My husband was declared dead at 1.47 am on August 2, 2021,' she stated. It was alleged that the doctors who performed the abdominal ascetic tap under the supervision of Dr Chabra on Harit were 'negligent in performing their duties'. The complainants, thus, filed a complaint at the Commission, seeking Rs 2 crore compensation. Fortis Hospital, Mohali, and its doctor in their reply submitted before the Consumer Commission that the complaint was misconceived, unwarranted and not maintainable against them as 'there has been no negligence, deficiency in service or unfair trade practice on their part in dealing with the patient. Further, the complaint is frivolous, vexatious and liable to be dismissed'. The hospital and the doctor further claimed that 'the complainants have not approached this Commission with clean hands, as the patient had life life-threatening condition of liver disease associated with alcohol dependence over a long period, which is associated with significant mortality. The patient was suffering from end-stage liver disease and its complications'. Further, it submitted that Dr Mohinish Chhabra is a DM in gastroenterology, and thus, he was competent to treat the patient. 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Once the order is in hand, we will conduct a thorough review and, guided by expert legal advice, take appropriate action as deemed necessary. Fortis Healthcare remains steadfast in its commitment to delivering world-class medical care with transparency and upholding the well-being and trust of our patients,' a spokesperson of Fortis Hospital, Mohali, said.
Hindustan Times
7 hours ago
- Hindustan Times
Health Talk: Taking the road to hepatitis elimination
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The Print
a day ago
- The Print
All about hepatitis D, deadly viral hepatitis given a ‘cancer' tag by WHO
Hepatitis D or HDV, which only affects individuals infected with hepatitis B, is associated with a two- to six-fold higher risk of liver cancer compared to hepatitis B alone, according to the IARC. Viral hepatitis, characterised by inflammation of the liver, can be caused by the five known hepatitis viruses—A, B, C, D and E. Among these, only hepatitis B, C, and D can lead to chronic infections that significantly increase the risk of cirrhosis, liver failure, or liver cancer. New Delhi: The World Health Organisation-International Agency for Research in Cancer (WHO-IARC) has now declared hepatitis D, a little-known but deadly viral hepatitis, as carcinogenic, expressing hope that this will lead to more screening and access to new treatments. It is estimated that globally, 48 million people are affected with HDV, which in combination with the hepatitis B virus, has the highest fatality rate of all the hepatitis infections, at 20 percent. Its prevalence is highest in low- and middle-income regions in Africa and Asia, apart from the Amazon basin and India. Scientific evidence has shown that 8-37 percent, depending on the region, of those infected with hepatitis B, also have HDV. A 2024 report by the WHO had said that India had over 3.5 crore cases of viral hepatitis—including 2.98 crore hepatitis B cases—in 2022, accounting for 11.6 percent of the total disease burden globally that year. Over 1.25 lakh people, the report suggested, had died due to hepatitis B and C in India that year. Senior gastroenterologists and public health professionals suggested that HDV is largely undetected in the country, mainly because of lack of screening, and is more prevalent in some parts of east India and among people infected with HBV. 'From a public health perspective, this classification by WHO-IARC highlights the importance of incorporating HDV awareness, screening, and prevention into the existing hepatitis B prevention programme,' Dr Saswata Chatterjee, gastroenterologist with the Calcutta Medical Research Institute (CMRI), told ThePrint. With liver cancer becoming a challenging burden, screening and early detection of co-infections, such as HDV, will be crucial in reducing chronic complications of viral hepatitis, he added. Also Read: Govt says no plan to ban heartburn drug ranitidine, carcinogenic impurities within safe limits HBV triggers rapid progression to end-stage liver failure Dr Piyush Ranjan, senior gastroenterologist with Sir Ganga Ram Hospital in Delhi, explained that HDV is a satellite virus that requires hepatitis B virus (HBV) for replication, causing the most aggressive form of viral hepatitis. Compared to hepatitis B and C, HDV leads to more rapid progression to cirrhosis and liver cancer. In clinical terms, explained CMRI's Dr Chatterjee, HDV occurs as a co-infection—when it is contracted simultaneously with HBV—or a superinfection—when an individual who is chronically infected with HBV becomes infected with HDV. While HBV increases the risk of developing liver complications, HDV increases this risk substantially, accelerating the progression of liver fibrosis, cirrhosis and malignancy. The mode of transmission of this hepatitis virus is similar to hepatitis B and C—through contaminated injections, mother to child, and sexual contact. Dr Vibhor Sharma, a medical oncologist with Asian Hospital, highlighted that co-dependency of HDV on HBV leads to making hepatitis worse in patients. 'HDV-triggered liver disease is more severe as it can result in end-stage liver failure in less than ten years,' he said, adding that as compared to the general population in India, this form of hepatitis is seen more commonly in intravenous drug users, HIV/AIDS patients and those with chronic HBV. The declaration by the WHO-IARC is crucial, said the medical oncologist as HDV, despite its aggressiveness in triggering liver cancers, is mostly undiagnosed and is grossly underreported in developing countries such as India. Prevention and management Clinicians say HDV is preventable at a low cost, through immunisation. The effective methods to prevent both HBV and HDV are the vaccines against hepatitis B, safe blood practices, sterilisation of medical equipment, and safe sex practices, said Dr Chatterjee. The HBV vaccine in India, as part of the Union government 's Universal Immunization Programme, was piloted in 2002-03 and then scaled up in the entire country in 2010 to protect children from the acute infection. It is now provided as part of the pentavalent vaccine at 6, 10 & 14 weeks apart from the birth dose of hepatitis B vaccine. However, a 2020 study from India said that although the coverage of third-dose hepatitis B vaccine has reached 86 percent in the country, the birth dose coverage was under 50 percent in 2015 despite high rates of institutional deliveries. The WHO says that while treatment with oral medicine can cure hepatitis C within 2 to 3 months and effectively suppress hepatitis B with life-long therapy, treatment options for hepatitis D are evolving. Sir Ganga Ram's Dr Ranjan maintained that for those already infected, management is challenging, with limited approved therapies, though newer agents like bulevirtide—an antiviral therapy especially developed against the condition—offer promise. 'The carcinogen tag will hopefully intensify global surveillance, funding, and research to curb the burden of HDV-associated liver cancer,' said the gastroenterologist. (Edited by Gitanjali Das) Also Read: Cancer warning on liquor bottles 'long overdue'. Even 'light', 'moderate' drinking poses threat
