A Snapshot of Liver Cancers
Incidence and Mortality
Primary liver cancer (including intrahepatic bile duct cancer) is the fifth most common cause of cancer death in men and the ninth most common cause of cancer death in women. Over the past two decades, incidence rates for these cancers have increased in people of all races and in both sexes. Overall mortality rates have been rising an average of 2.6 percent each year over 2002-2011. Men are about three times as likely as women to develop liver and intrahepatic bile duct cancers and more than twice as likely as women to die from these cancers. Asians/Pacific Islanders and American Indians/Alaska Natives have higher incidence rates of these cancers than people of other races/ethnicities.
Almost all cases of liver cancer in the United States occur in people with alcohol-related cirrhosis or who are chronically infected with hepatitis B virus (HBV) or hepatitis C virus (HCV). Obesity, diabetes, and iron storage disease are other risk factors for liver cancer. Vaccinating for HBV provides long-term protection from HBV infection and has been shown to lower the risk of liver cancer in children, although it is not yet known whether it lowers the risk in adults. There is no standard or routine screening test for liver cancer. Standard treatments for liver cancer include surgery, liver transplant, ablation therapy, embolization therapy, radiation therapy, chemotherapy, and targeted therapy.
Examples of NCI Activities Relevant to Liver Cancer
- The Tumor Microenvironment Network (TMEN) is exploring the role of the microenvironment in tumor initiation, progression, and metastasis. One TMEN center is investigating the role of two cell types, myofibroblasts and cancer-associated fibroblasts, in digestive cancers, including liver cancer.
- The Early Detection Research Network (EDRN) is identifying and testing new biomarkers to improve cancer detection and risk assessment. Several liver-relevant biomarkers are currently being investigated through the EDRN.
- A phase I/II trial Sorafenib and TRC105 in Hepatocellular Cancer is studying the safety and effectiveness of combining sorafenib and the experimental biological agent TRC105 for the treatment of patients with liver cancer that has not responded to other treatments.
- Researchers with The Cancer Genome Atlas (TCGA) program are systematically identifying the major genomic changes involved in more than 20 cancers, including liver cancer, using state-of-the-art genomic technologies.
- The Epidemiology and Genomics Research Program supports interdisciplinary and translational cancer research including the Hepatocellular Carcinoma Epidemiology Consortium, which links liver cancer investigators across the world for the purpose of pooling their research tools and resources to undertake large collaborative research projects that enhance knowledge and increase public awareness of liver cancer.
- The Cancer Etiology Branch supports research programs investigating biological, chemical, and physical agents that are known or possible carcinogens or co-carcinogens. One program area, DNA and RNA Viruses in Carcinogenesis, supports research that seeks to elucidate the role of the hepatitis virus in hepatocellular carcinoma, the most common type of liver tumor.
Selected Advances in Liver Cancer Research
- A study that compared the gene expression and cancer metabolite profiles of tumor and nontumor tissues from 30 patients with hepatocellular carcinoma found that expression of SCD (an enzyme involved in fatty acid metabolism) and aberrant lipid metabolite signaling were associated with cancer progression and poor patient outcomes. Published January 2013. [PubMed Abstract]
- In a nested case-control study, higher serum vitamin D levels were associated with a lower risk of death from chronic liver disease and, among participants with higher serum calcium levels, a lower risk of liver cancer, suggesting that vitamin D may be important in the etiology of liver cancer and chronic liver disease. Published September 2013. [PubMed Abstract]
- Studies using a newly developed cell culture system that is persistently infected with HCV revealed that HCV replication impairs the response to certain antiviral treatments by inducing internal cellular stress and an autophagy response. This finding raises the possibility that targeting chronic cellular stress and HCV-induced autophagy may overcome treatment resistance in chronic HCV infection. Published November 2013. [PubMed Abstract]
- A monoclonal antibody directed against GPC3, a molecule highly expressed in many hepatocellular carcinomas, blocked tumor growth in a xenograft mouse model, suggesting that this may be a novel strategy to pursue for liver cancer therapy. Published June 2014. [PubMed Abstract]
Trends in NCI Funding for Liver Cancer Research
NCI’s investment1 in liver and intrahepatic bile duct cancers research was $64.0 million in fiscal year (FY) 2013. In addition to the funding described in the graph, NCI supported $12.2 million in liver and intrahepatic bile duct cancers research in FYs 2009 and 2010 using funding from the American Recovery and Reinvestment Act.
Additional Resources for for Liver and Bile Duct Cancers
- What You Need To Know About™ Liver Cancer
Describes possible risks, symptoms, diagnosis, and treatment for someone recently diagnosed with liver cancer.
- Liver Cancer Home Page
NCI's gateway for information about liver cancer.
- Adult Primary Liver Cancer Treatment (PDQ®)
Expert-reviewed information summary about the treatment of adult primary liver cancer.
- Childhood Liver Cancer Treatment (PDQ®)
Expert-reviewed information summary about the treatment of childhood liver cancer.
- Clinical Trials for Liver Cancer
- 1 The estimated NCI investment is based on funding associated with a broad range of peer-reviewed scientific activities. For additional information on research planning and budgeting at the National Institutes of Health (NIH), see About NIH.