A Snapshot of Liver and Bile Duct Cancers

Incidence and Mortality

Primary liver and bile duct cancers are 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, the incidence rates for these cancers have increased in people of all races and in both sexes; mortality rates have increased in all groups except Asians/Pacific Islanders. Men are more than twice as likely as women to develop and die from liver and bile duct cancers, and African Americans and Hispanics are almost twice as likely to develop these cancers as whites. Although Hispanics and Asians/Pacific Islanders have lower incidence rates of most types of cancer than whites, they have much higher rates of liver cancer.

Liver cancer is closely associated with hepatitis virus infections, especially hepatitis B. Almost all cases of liver cancer in the United States occur in people who first had cirrhosis, usually resulting from hepatitis B or C infection or from heavy alcohol use. Ingestion of foods contaminated with aflatoxin and obesity may also increase liver cancer risk. Vaccinating for hepatitis B provides long-term protection from hepatitis B 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, radiation therapy, chemotherapy, percutaneous ethanol injection, and targeted therapy.

Trends in NCI Funding for Liver and Bile Duct Cancers Research

The National Cancer Institute's (NCI) investment¹ in liver and bile duct cancers research increased from $68.3 million in fiscal year (FY) 2007 to $72.6 million in FY 2010, before decreasing to $66.3 million in FY 2011. In addition to this funding, NCI supported $12.2 million in liver and bile duct cancers research in FY 2009 and 2010 using funding from the American Recovery and Reinvestment Act (ARRA)².

Examples of NCI Activities Relevant to Liver and Bile Duct Cancers

• NCI's Patterns of Care/Quality of Care (POC/QOC) Studies evaluate the dissemination of state-of-the-art cancer therapy into community practice and work with professional organizations to develop educational or training opportunities to improve the use of state-of-the-art cancer therapy in community practice. Liver cancer is among the cancers covered by these studies.
• The Tumor Microenvironment Network (TMEN) is exploring the role of the microenvironment - the cells and blood vessels that feed and support a tumor - in tumor initiation and progression. Network investigators are examining the role of myofibroblasts/cancer-associated fibroblasts in digestive cancers, including liver cancer.
• The Physical Sciences-Oncology Centers (PS-OC) are bringing together multidisciplinary teams of oncologists, physical scientists, and engineers to address major questions and barriers in cancer research. One center is focusing on novel methods to improve the treatment of liver cancer.
• The Etiology, Prevention, and Treatment of Hepatocellular Carcinoma program supports research on the etiology of liver cancer, the development of animal models, novel prevention approaches, the identification of reliable predictors of disease progression, and ways to minimize the morbidity and mortality associated with this disease.
• NCI supports studies that explore Biomarkers of Infection-Associated Cancers. One project is identifying changes in protein-associated glycans related to the development of hepatocellular carcinoma, which could be used for early detection of the disease.
• NCI supports early-phase clinical trials of targeted, personalized cancer regimens through the Accelerating Clinical Trials of Novel Oncologic PathWays (ACTNOW) program, including two trials studying treatments for advanced liver cancer.

Selected Advances in Liver and Bile Duct Cancers Research

• Genetically engineered mouse models may help researchers understand how obesity promotes liver cancer development. Reported June 2011.
• Results of a population-based study showed that metabolic syndrome is associated with an increased risk of liver cancer in the United States. Published June 2011. [PubMed Abstract]
• Researchers discovered new protein interactions that may be important for liver cancer development. Published October 2011. [PubMed Abstract]
• Researchers discovered a protein critical for hepatitis C virus entry into cells and showed that blocking this protein prevents infection in cell and animal models, suggesting that it may serve as a target for new therapeutic interventions. Published January 2012. [PubMed Abstract]
• See this PubMed list of selected free full-text journal articles on NCI-supported research relevant to liver cancer. You can also search PubMed for additional scientific articles.