Alcohol consumption is already responsible for more than half of liver cancer cases

A loud and clear message from hepatologists who are very active in the fight against alcohol use in Spain. First a warning: It already causes more than half of liver cancer cases. Moreover, alone or in combination with other reasons, it represents up to 55% of liver cancer cases, the second with the most years of life left. But, in addition, experts criticize: the evolution of its etiology in the period from 2008 to 2023.”shows the failure of policies to combat alcohol consumption, which remains stable in Spain as the leading cause of hepatocellular carcinoma (HCC).”

Slap on the occasion of the 49th Congress of the Spanish Society for the Study of the Liver (AEEH), which will take place from 14 to 16 February in Madrid and where more than 900 specialists are expected to attend, will discuss the “alarming increase in liver pathologies and their impact at increasingly younger ages, even among young people.” and teenagers.” In Spain they are diagnosed every year. 6600 new cases of liver cancerhalf of them are in very advanced stages, and are the leading cause of death in patients with liver cirrhosis caused by alcohol consumption or viral hepatitis.

Celebrating this scientific meeting coincides with two important milestones, the scientific community notes. On the one hand, the Ministry of Health announced a preliminary draft to prevent and combat minors alcohol consumption, which has become “into an enemy of society who needs to be beaten for liver health.” On the other hand, the tenth anniversary of the approval of the first direct acting antiviral (DDA) by the European Medicines Agency. who managed to cure hepatitis C.

Prevention

At the Madrid Congress The results of the III Registry of Hepatocellular Carcinoma (HCC) will be presented, which collected demographic and clinical data of 767 patients diagnosed with a primary liver tumor, extracted from 52 hospital centers in the period from October 1, 2022 to January 31, 2023. These data, experts note , allow us to know the evolution etiology of liver cancer over the past fifteen years in our country and indisputably show that alcohol consumption is its main cause, regardless of whether it is considered in isolation (29.9% of cases) or associated with other causes (54.9% of cases).

These data, according to hepatologists, show “a failure of policy to combat alcohol usewho have failed to reverse this problem as the underlying cause of hepatocellular carcinoma, which remains stable.” that almost six out of every ten cases of liver cancer in Spain are caused by this substance.

Experts add that, in addition, there are “two paradoxical and at the same time merging circumstances: with liver cancer This is the type of cancer that takes the most years of life from the population.Perceptions of the risks of drinking alcohol in our country remain unchanged, and in fact young people are starting to drink at increasingly younger ages and in high-risk patterns (drinking large amounts of alcohol over several hours).”

Uncontrollable fatty liver

In the same time, III Register of Hepatocellular Carcinoma AEEH is seeing an increase in this tumor in people with milder stages of liver disease, without the presence of cirrhosis, almost doubling, from 4.2 to 7.9% of cases,” and clearly shows an increase in the incidence of liver cancer caused by metabolic liver diseases. violations. steatosis, EGmet, is the name given to fatty liver pathology.

Compared to data from 2008 and 2014, the results of the Register show an increase of almost ten points (1.9% vs 5.9% and 11.8%) in the percentage of hepatocellular carcinoma caused by EHmet, which is confirmed as the third cause of liver cancer and one that represents faster growth– hepatologists tell in detail.

“This trend is worrying.and many experts who actually believe that steatohepatitis will become the leading cause of HCC within a decade, given the progress in the prevalence of fatty liver. In fact, it is assumed that this pathology affects to more than ten million Spaniards, of which almost two million will have liver inflammation (steatohepatitis), and 400,000 of them will already have cirrhosis, with an aggravating factor that in most “They haven’t been diagnosed yet.”.

“Unstoppable progress” that is concerning “for many reasons, and especially because of the impact it may have on liver cancer.” “Presence of liver cancer in patients The number of cases of fatty liver in Spain has tripled in the last decade, and these data all indicate the scale of the problem that we will have to face,” says the AEEH President, Manuel Romero.

Good news”

The “good news,” experts conclude on the eve of their scientific congress, is the continued decline in the weight of hepatitis C (HCV) in the total number of HCC cases, whichOver fourteen years it decreased from 43% to 17.5%. “A milestone that allowed us to turn 180 degrees in the history of this infectious disease and what today confronts our country with the possibility of achievingThis is a great public health achievement: its elimination in just three decades after detection of the virus, for which it will be necessary to carry out last verification attemptespecially among vulnerable groups of the population,” doctors note.

Despite this progression, they explain, it is still the second risk factor for liver cancer, so they are “calling for a last-ditch effort.” achieve its eliminationwhich largely involves increased screening among vulnerable populations and facilitate access to treatment“.

Moreover, data from the III AEEH Register not only show that epidemiology liver cancer is changing, but also that efforts to increase detection “through screening programs have proven insufficient.” In this sense, they highlight that the proportion of patients with cirrhosis diagnosed with cancer in screening programs has not changed and is therefore “not gaining momentum.” At present, 43% of cases are detected outside of these programs.

The problem, doctors say, is that when diagnosis of hepatocellular carcinoma carried out without screening, the disease is detected at a more advanced stage where they are least likely to be offered curative treatment, which leads to a significantly worse prognosis. These results highlight the need to improve liver cancer screening programs.