As liver cancer rates and mortality continue to rise, advocacy and policy efforts are important

During a session at the 20th Annual Meeting of the International Society of Gastrointestinal Oncology, Sarah Manes, director of the liver cancer program at the Global Liver Institute, highlighted related unmet needs. to liver cancer and discussed the organization’s mission to advance research and address health disparities.

Liver cancer is the sixth most common cancer and the third deadliest cancer in the world. Ms. Manes noted that there are not many cancers that are stagnant today. Most cancers in terms of incidence and morbidity/mortality are decreasing or at least stable. Liver cancer is one of very few cancers [where] Morbidity is increasing and mortality is increasing even more steadily.

The World Health Organization estimates that by 2040, there will be 1.4 million new cases of liver cancer and 1.3 million deaths from liver cancer annually. Men 65 years of age and older have the highest incidence of liver cancer, and Hispanics have the highest incidence of liver cancer. Additionally, 70% of liver cancer cases are preventable with available knowledge and technology. According to Ms. Manes, we really have a huge obligation and ability to be able to limit those numbers.

The biggest risk factors for hepatocellular carcinoma are:

• Hepatitis B (44.0%)
• Alcohol (26.0%)
• Hepatitis C (21.0%)
• Smoking (13.0%)
• Obesity (9.0%)
• Diabetes (7.0%)
• Aflatoxin (4.6%-28.2%)

The Global Liver Institute, a patient advocacy and policy organization, is seeking to:

• Change the culture by reducing stigma and increasing voices for liver health
• Improve liver health and patient outcomes by redesigning health systems
• Advanced policy by putting liver issues on the global public health agenda with legislative, regulatory and reimbursement frameworks

The organization is committed to doubling the 5-year survival rate for liver cancer in the United States by:

• Increase the number of liver cancer patients diagnosed in the early stages
• Support knowledge, choice and access to appropriate treatment options
• Reduce disparities in access to diagnosis and treatment
• Promote policy and advocacy to support research, outreach and information for people affected by liver cancer

Ms. Manes then discussed disparities related to liver cancer and emphasized the need for continued advocacy, research, and awareness and education. She noted that 60% of uninsured individuals do not receive screening and prevention services. What does that do to build and put pressure on our health care system, and how does that impact health disparities and equity? she asked. Ms. Manes noted that research should be more targeted to represent a more diverse population, as clinical trial populations are often not always representative of the general patient population. She advocates for policy work and funding to expand Medicare and Medicaid to advance health equity goals. To raise awareness, she highlighted the #OctoberIs4Livers campaign to highlight October as Liver Cancer Awareness Month.

Ms. Manes concluded by discussing the importance of a multidisciplinary team in providing person-centered care, including:

• Early screening
• Address referral source fragmentation
• Establish overall goals/make treatment decisions
• Clinical trial information
• Individualized/modularized patient education
• Emotional and social support/peer mentoring
• Work with a multidisciplinary care team
• Second opinion
• Managing costs of care and cancer-related financial toxicities
• Carriage
• Physical activity
• Nutrition

Global Liver Institute is committed to creating resources for patients and families in multiple languages. We must commit to doing more than just providing written resources in different languages. How do we work with learning styles? How do we work with rural areas, both in North America and the United States as well as on a global basis, what does reaching rural areas look like? she concluded.

Learn more about the Global Liver Institute.