The liver is the largest organ in the body and is responsible for over 500 functions, including the secretion of glucose, proteins, vitamins, and fats; the production of bile; the processing of hemoglobin; and detoxification of numerous substances. Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer. Hepatitis C is an infection of the liver and one of the leading causes of liver cancer.

Statins are cholesterol-lowering drugs and are the most commonly prescribed class of prescription drugs in the United States. Some studies have suggested that in addition to their cardiovascular effects, statins may help to reduce the risk of certain cancers, including prostate cancer and colorectal cancer.[2][3] However, other studies have demonstrated little evidence that statins reduce risk.[4][5]

To examine the relationship between statins and liver cancer among individuals with hepatitis C (HCV), researchers conducted a population-based cohort study of 260,864 HCV-infected patients enrolled in the Taiwan National Health Insurance Research Database. Patients were followed from 1999 to 2010, during which time about 13 percent of patients (35,023) filled a prescription for statins.

During the course of follow-up, there were 27,883 cases of liver cancer in the cohort. Among the 35,023 patients using statins, 1,378 had liver cancer. Among the 225,841 patients not using statins, 26,505 developed liver cancer. After the researchers accounted for patients’ age, gender and other diseases, they found those who took statins were about half as likely to get cancer as non-statin users. Higher doses of statins, as well as longer-term use, were linked to a further drop in cancer risk.

The researchers concluded that among people with hepatitis C, statin use was associated with a reduced risk of liver cancer; however, they are quick to point out that this doesn’t prove that statins prevent cancer. The data isn’t strong enough to warrant prescribing statins for liver cancer prevention; however, the researchers did not find a link between statins and any complications in this population—meaning that doctors do not need to avoid prescribing statins in people with hepatitis C.

References:

The liver is the largest organ in the body and is responsible for over 500 functions, including the secretion of glucose, proteins, vitamins, and fats; the production of bile; the processing of hemoglobin; and detoxification of numerous substances. Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer. Hepatitis C is an infection of the liver and one of the leading causes of liver cancer.

To evaluate the link between antiviral therapy and subsequent risk of liver cancer, researchers performed a systematic review and meta-analysis of eight randomized clinical trials comparing antiviral therapy versus placebo or no intervention. Nearly 1,200 patients in the studies received antiviral therapy, most often interferon. Antiviral treatment continued for six months to a year and patients were monitored for 5-8 years after treatment. These patients were compared with nearly 1,200 patients who did not receive antiviral treatment.

During follow-up, 81 patients who received antiviral therapy were diagnosed with liver cancer, compared with 129 patients who did not receive antiviral therapy. The researchers concluded that antiviral therapy reduced the risk of liver cancer by 47 percent.

The rate of liver cancer is on the rise in the U.S.—in part due to rising rates of hepatitis C. Treating hepatitis C with antiviral therapy could reduce subsequent risk of liver cancer.

Reference:

Kimer N, Dahl EK, Gluud LL, Krag A. Antiviral therapy for prevention of hepatocellular carcinoma in chronic hepatitis C: systematic review and meta-analysis of randomised controlled trials. BMJ Open 2012; 2:e001313 doi:10.1136/bmjopen-2012-001313.

A growing body of evidence suggests that aspirin may reduce the risk of several types of cancer, with particularly strong evidence for colorectal cancer. Not all studies have found a benefit, however, and any potential benefits of aspirin must be weighed against risks such as bleeding.

To further explore the relationships between daily aspirin and cancer, researchers conducted a combined analysis of 51 previous randomized trials.[1] The trials were originally designed to evaluate the effect of daily aspirin on outcomes such as heart disease, but information about cancer was also available.

• Daily aspirin reduced cancer deaths. After five years, aspirin users had a 37 percent reduction in risk of cancer death.
• Aspirin also reduced the likelihood of developing cancer. From three years onward, aspirin users had a 24 percent reduction in the risk of being diagnosed with cancer.
• As expected, aspirin carried a risk of major bleeding, but this risk appeared to diminish over time.

Another study published in the same issue of The Lancet evaluated the effect of daily aspirin on cancer metastasis (the spread of cancer from its original site to other parts of the body). The study focused on 987 people who were diagnosed with cancer while participating in one of five trials of aspirin use. Those who were taking aspirin were less likely to have metastatic cancer than those who were not taking aspirin.[2]

These results suggest that regular aspirin use may reduce cancer incidence and mortality, but concerns remain about the risks of regular aspirin use in healthy individuals. People who are considering using aspirin on a regular basis are advised to discuss the risks and benefits with their physician.

References:

The liver is the largest organ in the body and is responsible for many vital functions. Among other things, the liver removes harmful substances from the blood, contributes to the digestion of food, and stores nutrients and energy.

Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer (cancer that begins in the liver). Factors that increase the risk of developing HCC include long-term, heavy alcohol use and chronic infection with hepatitis B or C viruses.

Liver cancer is the third leading cause of cancer death worldwide. Historically, rates of HCC have been lower in the United States than in other countries, but the disease is on the rise.

To explore trends in HCC in a single, well-defined population, researchers collected information about liver cancer cases diagnosed in Olmsted County, Minnesota. Information was available about 104 people who had been diagnosed between 1976 and 2008.

• The frequency of new cases increased over time. The number of new cases per 100,000 people per year was 3.5 during 1976-1990, 3.8 during 1991-2000, and 6.9 during 2001-2008.
• Alcohol use was the most common risk factor among cases diagnosed during the earliest two time periods. In the most recent time period (2001-2008), hepatitis C was the most common risk factor, and was found in close to 45 percent of the cases.
• Liver cancer survival also increased over time. Median survival increased from 3 months in the earliest time period to 9 months in the most recent time period.

These results provide additional evidence that the frequency of liver cancer has increased sharply in the US, and that chronic infection with hepatitis C is a major contributor.

Reference: Yang JD, Kim B, Sanderson SO et al. Hepatocellular carcinoma in Olmsted County, Minnesota, 1976-2008. Mayo Clinic Proceedings. 2012;87:9-16.

In 2010, more than 28,000 solid organ transplants were performed in the United States. These procedures can be life-saving for people with advanced organ disease.

Cancer risk is known to be elevated among transplant recipients. Immunosuppression is thought to play an important role in this increased risk, but other factors may contribute as well.

To further explore cancer risk among transplant recipients, researchers collected information about 175,732 transplants. The median age at the time of transplant was 47. The most common types of transplanted organs were kidney (58%), liver (22%), heart (10%), and lung (4%).

• During follow-up, more than 10,000 cases of cancer occurred among transplant recipients. This is roughly twice what would be expected in the general population. Risk was increased for cancers related to infection (e.g. non-Hodgkin lymphoma, Kaposi sarcoma, Hodgkin lymphoma, and cancers of the liver, stomach, oropharynx, anus, vulva and penis) as well as several other types of cancer.
• Of the cancers that were more common in transplant recipients, the four most common were non-Hodgkin lymphoma, lung cancer, liver cancer, and kidney cancer. Risk of non-Hodgkin lymphoma was increased for recipients of any type of organ. For lung cancer, risk was greatest among lung recipients, but was also increased for recipients of other types of organs. Risk of liver cancer was elevated only among liver recipients. Risk of kidney cancer was highest among kidney recipients, but was also increased for liver and heart recipients.

The study suggests that organ transplant recipients are at increased risk for a wide range of cancers. The reasons for this have not yet been fully explored, but possible explanations include loss of immunologic control of cancer-associated viruses, chronic immune disturbance or inflammation, underlying medical conditions, and medication toxicity.

Reference: Engels EA, Pfeiffer RM, Fraumeni JF et al. Spectrum of cancer risk among US solid organ transplant recipients. JAMA. 2011;306:1891-1901.

Cancer screening involves the use of tests to detect cancer at an early stage in people with no symptoms of the disease. Commonly used screening tests include mammography for breast cancer, colonoscopy for colorectal cancer, and the prostate-specific antigen (PSA) blood test for prostate cancer.

People who are at high risk of a particular cancer as a result of their personal or family medical history may be advised to undergo earlier or more frequent cancer screening, or to be screened with more sensitive tests. Women who have a high risk of breast cancer, for example, are often advised to begin screening at an earlier age than other women, and to be screened with both mammography and magnetic resonance imaging (MRI).

Family history of cancer can change over time, and changes in family history may affect which screening tests and schedules are recommended. To explore how often this occurs, researchers collected information from a large database of US adults with a personal and/or family history of cancer.

• The number of people who were candidates for high-risk colorectal cancer screening as a result of family history increased from 2.1% at age 30 to 7.1% at age 50.
• The number of people who were candidates for high-risk breast cancer screening as a result of family history increased from 7.2% at age 30 to 11.4% at age 50.
• The numbers for prostate cancer were smaller, but increased from 0.9% at age 30 to 2.0% at age 50.

These results suggest that family history of cancer (and the screening recommendations that may stem from family history) can change significantly during adulthood. The researchers recommend that healthcare providers collect updated family history information from patients at least every five to ten years.

Reference: Ziogas A, Horick NK, Kinney AY et al. Clinically relevant changes in family history of cancer over time. Journal of the American Medical Association. 2011; 306:172-178.

Worldwide, an estimated 3.5% of all cancer deaths are attributable to alcohol. Links have been established between alcohol and several types of cancer, including cancers of the mouth, pharynx, larynx, esophagus, breast, colon and rectum, and liver.

Researchers in this current study used data from the ongoing European Prospective Investigation Into Cancer (EPIC) study and from the World Health Organization to estimate the percentage of cancers that can be attributed to alcohol intake. Data were used from almost 364,000 participants in eight European countries (France, Italy, Spain, the Netherlands, United Kingdom, Greece, Germany, and Denmark). They determined that approximately 10% of all cancers in men and 3% of all cancers in women were related to alcohol use. Cancers that appeared to be related to alcohol consumption included breast, colon, rectal, esophageal, head and neck, and liver cancers.

Another notable finding is that even moderate amounts of alcohol can contribute to cancer risk. Though cancer risk grows with increasing intake, any amount of consumption may elevate risk, according to the researchers. This was explained in a press release from a sponsor of the EPIC study: “The cancer risk increases with every drink, so even moderate amounts of alcohol—such as a small drink each day—increases the risk of these cancers.”

According to the World Cancer Research Fund and the American Institute for Cancer Research, alcohol consumption should be limited to no more than two drinks per day for men and one drink per day for women. However, as these findings suggest, even a moderate level of alcohol consumption may elevate risk, making no amount entirely safe.

Reference: Schütze M, Boeing H, Pischon T, et al. Alcohol attributable burden of incidence of cancer in eight European countries based on results from prospective cohort study. BMJ. 2011 Apr 7;342:d1584. doi: 10.1136/bmj.d1584.

A report on the status of cancer is published each year by the National Cancer Institute, the North American Association of Central Cancer Registries, the Centers for Disease Control and Prevention, and the American Cancer Society. Findings are comprised of information collected from these four institutions.

As a group, women took up smoking in the middle of the twentieth century, which resulted in an increase in smoking-related illnesses. Thanks to a more recent decline in smoking among women, lung cancer deaths are also decreasing.

Following a peak in lung cancer deaths among women in 2002, the rate declined by about 1% through 2007 (the final year included in the report). According to one researcher on the study, this marks a “statistically significant decline.”

In addition the findings on lung cancer among women, the report shows other areas of decline in both cancer incidence and death. Promising news includes a drop in diagnoses and deaths for common cancers among all Americans (all racial and ethnic groups). Fewer incidences of lung and colorectal cancer in men and lung, breast, and colorectal cancer in women are cited as the main cause of this decline. Deaths have also declined from prostate, ovarian, kidney, stomach, and brain cancers. Falling mortality rates are attributed to advances in screening and treatment as well to a drop in smoking rates.

Findings from the report, however, are not positive for all diseases. Rates of diagnosis and death are increasing for melanoma as well as liver, pancreatic, and uterine cancers. It is thought that obesity and hepatitis are driving the rise in liver cancer and that sun exposure is contributing to the increased incidence of melanoma.

The decline lung cancer mortality among women and the decrease in overall cancer incidence and death among all Americans is encouraging, but the researchers conclude that continued progress in the prevention, detection, and management of the disease is still needed. As the U.S. population ages, more people will be at risk for common cancers, and effective measures to control these diseases remain critical.

Reference: Annual report to the nation shows continuing decline in cancer mortality [memo to the media]. Journal of the National Cancer Institute [early online publication]. March 31, 2001.

The liver is the largest organ in the body and is responsible for over 500 functions, including the secretion of glucose, proteins, vitamins, and fats; the production of bile; the processing of hemoglobin; and detoxification of numerous substances. Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer (cancer that begins in the liver). Factors that increase the risk of developing HCC include long-term, heavy alcohol use and chronic infection with hepatitis B or C viruses.

Hepatocellular carcinoma is the third leading cause of cancer deaths worldwide. Historically, the rates of HCC have been lower in the United States than in other countries; however, the disease is on the rise. The incidence of liver cancer in the United States tripled between 1975 and 2005, but survival rates are improving, according to the results of a study published in the Journal of Clinical Oncology.[2]

To evaluate the most current data on HCC incidence, researchers analyzed HCC cases from 2001-2006 from the CDC’s National Program of Cancer Registries as well as from the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) system. In 2001, the average annual incidence rate of HCC was 2.7 per 100,000 people and increased to 3.2 in 2006. The researchers also reported that HCC incidence was three times higher for males than females. When the researchers looked at incidence of HCC by race or age, the largest increases in incidence from 2001 to 2006 were among whites, blacks, and individuals between 50 and 59 years old. The researchers also reported that the lowest incidence of HCC is in the state of South Dakota and the highest is in Hawaii.

The incidence of HCC increased from 2001 to 2006 in the United States. Results from other studies suggest that diabetes prevention as well as avoidance of heavy alcohol use and hepatitis B and C virus infections could make an important contribution to HCC prevention in the United States.

References:

[2] Altekruse SF, McGlynn KA, Reichman ME. Hepatocellular carcinoma incidence, mortality, and survival trends in the United States from 1975 to 2005. Journal of Clinical Oncology. 2009; 27: 1485-1491.

Hepatocellular carcinoma is the most common type of primary liver cancer (cancer that begins in the liver). Factors that increase the risk of developing HCC include long-term, heavy alcohol use, chronic infection with hepatitis B or C viruses, diabetes, obesity, and certain rare metabolic disorders.

To evaluate the extent to which each of these risk factors contributes to HCC incidence in the United States, researchers evaluated information from large national databases. Information was collected for more than 5,600 people with liver cancer and more than 190,000 people without liver cancer.

• 63% of HCC cases were associated with at least one of the evaluated risk factors.
• Diabetes was associated with the highest percentage of cases (33.5%), followed by alcohol-related disorders (23.9%), hepatitis C virus infection (20.7%), hepatitis B virus infection (5.7%), rare metabolic disorders (3.1%), and obesity (2.7%).
• The extent to which these factors contributed to HCC varied by sex and race.

These results suggest that diabetes prevention could make an important contribution to HCC prevention in the United States. Avoidance of heavy alcohol use and hepatitis B and C virus infections is also important.

Reference: McGlynn KA, Quraishi S, Welzel TM et al. Attributable risks for hepatocellular carcinoma in the United States. Presented at the 101^st annual meeting of the American Association for Cancer Research. April 17-210, 2010. Washington, DC. Abstract 1816.