AsianScientist (Oct. 27, 2021) – Each October, liver cancer patients and their supporters put on emerald green ribbons and unite for Liver Cancer Awareness Month, a global effort to fight a dreadful disease that kills over 800,000 people every year. Also known as hepatocellular carcinoma (HCC), liver cancer is the third leading cause of cancer-related deaths. The burden is particularly high in Asia Pacific, where 72 percent of liver cancer deaths are found.
Asia’s increasing liver cancer burden is due partly to its high rates of viral hepatitis. Patients chronically infected with hepatitis B virus, for example, have a 100 times greater risk of developing liver cancer than someone who is not a carrier, noted Professor Pierce Chow from the National Cancer Centre Singapore. Growing rates of fatty liver disease are also contributing to the problem.
Liver cancer is sometimes described as a ‘silent killer’ because it is often diagnosed late. Yet healthcare leaders across Asia Pacific are working to improve the situation in many ways, such as through regular HCC surveillance testing in at-risk patient populations, national screening programs for viral hepatitis and other innovative strategies.
Improving liver cancer policy in Thailand
Over 27,000 cases of liver cancer are recorded in Thailand each year, making it the most frequently diagnosed type of cancer in the country. Due to gaps in diagnostic services, many patients only discover their condition at advanced stages when the only available option is palliative care. This is particularly true in rural areas, where hospitals often lack healthcare specialists and the equipment needed to perform basic diagnostic scans.
To tackle this national problem, Thailand’s Ministry of Public Health (MoPH) is building upon the country’s universal healthcare coverage scheme (UCS).
“In breast, colon and cervical cancers, the UCS has provided nationwide access to screening programs and therapies, even in rural areas,” said Dr. Terachai Songkiatkawin, co-president of the MoPH’s Cancer Service plan.
As annual treatment costs for liver cancer increase for Thailand, Songkiatkawin highlighted that the MoPH is looking to launch policies to increase public awareness of early liver cancer screening. Digital monitoring tools could also someday be applied for liver cancer, bringing Thailand into the future of liver cancer screening.
Championing patient awareness in Taiwan
Liver disease is also a serious public health issue in Taiwan, where roughly 15 to 20 percent of adults are hepatitis B virus carriers, and 2 to 5 percent are infected with hepatitis C virus. As these infections could lead to liver cancer, high-risk individuals are a key target audience for liver cancer awareness efforts.
To improve outcomes and lessen Taiwan’s overall liver disease burden, local NGOs like the Hao Xin Gan (Good Liver) Foundation are dedicated to driving patient awareness and education about various liver diseases. Since it was founded in 1994, the foundation has performed over 700 free disease screenings, held more than 1,000 liver disease awareness sessions, and conducted over 300,000 telephone consultations through a toll-free line.
These patient awareness initiatives have already made a substantial impact, according to Professor Yang Pei-Ming from the Good Liver Foundation.
“Due to dedicated healthcare efforts, [liver cancer] has now decreased from the leading cause of death to the fourth leading cause,” he said.
Despite recent progress, Yang noted that the fight continues. Taiwan’s department of education, for instance, will soon be launching a program for educating elementary students about liver disease. For adults over 40 years of age, the next step would be to emphasize the importance of undergoing annual liver ultrasound examinations, moving from awareness to action.
Policy meets practice in Japan
Japan is widely considered to be a global leader in liver cancer surveillance. Through regular ultrasonography and tumor marker assays, as well as optional CT and MRI scans, high-risk patients are identified at early stages, leading to better patient outcomes (around 62 percent of liver cancer patients are diagnosed at stages A and B, with up to 44 percent surviving even after five years).
While high-risk patients are the priority, Japan has also adopted a risk stratification strategy to assess younger and healthier segments of the population through efforts like workplace screenings, increasing the proportion of cancer cases that are detected early. However, the country’s surveillance strategy could still be improved, noted hepatologist Dr. Shun Kaneko.
Fortunately, improved diagnostic technologies and treatment options are being developed and deployed across the country. Bolstered by evolving government policies and the energy of passionate healthcare professionals, new hope for liver cancer patients and at-risk populations is on the horizon.
For more insights about the power of clinical lab diagnostics in tackling liver disease and other healthcare challenges in Asia, please visit Lab Insights, a data hub and educational content platform for clinical lab and healthcare professionals in the Asia Pacific region and beyond.
Asian Scientist Magazine is a media partner of Roche Diagnostics Asia Pacific.
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