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Persons with chronic hepatitis C (a viral infection that causes inflammation of the liver) combined with a heavy alcohol intake are at an increased chance for developing liver cancer.

Primary liver cancer, sometimes called hepatocellular cancer, is characterized by cancer that starts in cells of the liver and can spread through blood and lymph vessels to different parts of the body. 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 the detoxification of numerous substances. There is a very strong association between the development of hepatocellular cancer in persons with viral hepatitis B or cirrhosis (fibrosis) of the liver, but the association between liver cancer and viral hepatitis C is not well defined.

In order to better determine the risks of liver cancer, researchers in Japan recently evaluated 153 persons diagnosed with chronic hepatitis C. Fifteen years after the diagnosis of hepatitis C, 42% of these persons had developed liver cancer. The researchers discovered 3 distinct variables that were strongly associated with an increased risk of liver cancer: age greater than 50 years, high levels of alcohol intake, and the extent of damage to the liver from chronic disease (established through small samples of liver tissue examined under a microscope). From these results, researchers confirmed that hepatitis C and high levels of alcohol intake do have a strong association in the development of primary hepatocellular liver cancer.

Because of the strong association between chronic hepatitis C and the development of liver cancer, it seems reasonable that further studies will evaluate the use of antiviral agents in order to slow progression of viral damage to the liver and perhaps delay or prevent the development of liver cancer. Persons with hepatitis C may wish to talk to their physicians about the use of an antiviral agent or about the risks and benefits of participating in a clinical trial utilizing antiviral strategies. An easy to use listing of ongoing clinical trials involving hepatitis C is provided by the National Institutes of Health ( Persons who have liver cancer may wish to speak with their treating physician about the risks and benefits of participation in a clinical trial involving promising new cancer treatments.

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(Cancer, Vol 89, No 1, pp 53-59, 2000).