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, 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. African Americans, Asians/Pacific Islanders, Hispanics, and American Indians/Alaska Natives are more likely to develop these cancers than whites. This much higher risk for Hispanics and Asians/Pacific Islanders is in contrast to most other types of cancer, for which their risks are lower than those in whites.
Liver cancer is associated closely with hepatitis virus infections, especially hepatitis B. Almost all cases of liver cancer in the United States occur in people with alcohol-related cirrhosis or chronic hepatitis B or C infection. Obesity and diabetes are also associated with increased 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. New treatments currently being tested include hyperthermia therapy and biological therapy.
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 therapies into community practice and work with professional organizations to develop educational or training opportunities to improve the use of state-of-the-art cancer therapies 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 Early Detection Research Network (EDRN) is identifying and testing new biomarkers to enhance cancer detection and risk assessment. Several projects in the G.I. and Other Associated Cancers Research Group are focused on biomarkers for the early detection of liver cancer.
- NCI supports the Phase I/II Study of TRC105 in Combination with Sorafenib in Hepatocellular Carcinoma, a clinical trial studying the safety and effectiveness of combining sorafenib and TRC105 for the treatment of patients with liver cancer who cannot receive surgery or other local therapies.
- NCI supports studies that explore Biomarkers of Infection-Associated Cancers. One project is investigating circulating microRNAs as potential biomarkers to monitor people infected with hepatitis C virus for the development of liver cancer.
- Several early-phase clinical trials of targeted, personalized cancer regimens are being conducted through NCI's 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
- An analysis of two observational studies found an association between higher vitamin E intake from food or supplements and a lower risk of liver cancer. Published July 2012. [PubMed Abstract]
- Researchers demonstrated that the loss of a liver-specific microRNA triggered tumor development in mice and that treating animals with this microRNA slowed tumor growth in a liver cancer mouse model. Published July 2012. [PubMed Abstract]
- A study in mice showed that treatment with a drug that inhibits iNOS (an enzyme that helps produce nitric oxide) reduced the formation of liver tumors associated with a common genetic deletion. Published February 2013. [PubMed Abstract]
- Scientists developed a diagnostic test to assist in identifying those patients with liver cancer who are likely to benefit from adjuvant interferon-alpha therapy. Published March 2013. [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 or to complete a search tutorial.
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 decreased from $75.1 million in fiscal year (FY) 2008 to $64.7 million in FY 2012. In addition to this funding, NCI supported $12.2 million in liver and bile duct cancers research in FY 2009 and FY 2010 using funding from the American Recovery and Reinvestment Act (ARRA).
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.
- 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.