NASH is the “fastest growing cause” of liver cancer deaths worldwide

August 11, 2022

2 minute read

Disclosures: Loomba reports consulting for 89 Bio, Aardvark Therapeutics, Altimmune, Amgen, Anylam/Regeneron, Arrowhead Pharmaceuticals, AstraZeneca, Bristol Myers Squibb, CohBar, Eli Lilly, Galmed, Gilead, Glympse Bio, Hightide, Inipharma, Intercept, Inventiva, Ionis , Janssen Inc., Madrigal, Merck, Metacrine Inc., NGM Biopharmaceuticals, Novartis, Novo Nordisk, Pfizer, Sagimet, Theratechnologies, Terns Pharmaceuticals and Viking Therapeutics; and is a co-founder of LipoNexus Inc. Please see the study for relevant financial information from all other authors.

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Despite the global decline in liver cancer mortality attributed to hepatitis B and C, liver cancer mortality has risen sharply in the Americas, driven by an increase in nonalcoholic steatohepatitis, according to data published in Cell metabolism.

“NASH is the fastest growing cause of hepatocellular carcinoma in the Americas and the age-adjusted cause of liver cancer death worldwide,” study co-author Rohhe Loomba, MD, MHSc, professor of medicine, director of hepatology and the NAFLD research center and vice chief of gastroenterology at the University of California, San Diego, Healio told Healio. “Urgent action is needed globally to address the underlying metabolic risk factors and slow the growing burden of NASH-related liver cancer.”

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Using data from the 2019 Global Burden of Disease Study, Loomba and colleagues estimated trends in liver cancer burden and contributions of liver disease etiologies in 204 countries and territories from 2010 to 2019.

They identified 484,577 deaths worldwide from liver cancer in 2019, compared to 386,342 deaths in 2010. Although the researchers reported a 25% increase in liver cancer deaths and a 27% increase in cases of liver cancer during this period, they noted no significant change in age. standardized mortality and incidence rates.

Rohit Loomba

“Growth, as well as aging, of the global population may contribute to the observed disconnect in temporal trends in frequency and age-standardized incidence and mortality rates,” the researchers wrote.

Additionally, age-standardized death rates (ASDR) from liver cancer increased only in the Americas from 2012 to 2019 (annual percent change [APC] = 1.09%; 95% CI, 0.97-1.22).

Globally, NASH was the age-adjusted cause of liver cancer death (APC=0.70%; 95% CI, 0.43-0.97) during the period study, followed by alcohol (APC = 0.23%; 95% CI, 0.09-0.37). The largest increase in alcohol-related liver cancer was reported in the Americas (APC = 1.78%; 95% CI, 1.64-1.93).

“Global per capita alcohol consumption is expected to increase further, particularly in the Western Pacific and Southeast Asia,” Loomba said. “Implementation of policies such as increased alcohol pricing and taxation can be considered at the national level to reduce the burden of alcohol-associated liver cancer in high alcohol consumption countries. per inhabitant.”

Despite the worldwide increase in NASH- and alcohol-related liver cancer deaths, researchers reported that liver cancer ASDs due to hepatitis B (APC = -0.20%; 95% CI %, -0.31 to -0.09) and hepatitis C (APC = -0.62%; 95% CI, -0.79 to -0.46) decreased.

“The incidence of liver cancer due to NASH is expected to increase further over the next decade in the United States, Europe and Asia,” Loomba said. “We need to better understand the gene-environment interaction that is driving the rise in NASH-related HCC worldwide, [namely] what causes NAFLD-related HCC in non-cirrhotics and how can we intervene to reduce the risk of NASH-related HCC? »

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