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Cancer Risk Assessment for Liver Cancer

When the cells anywhere in your liver are found to have grown in an abnormal manner, it is called liver cancer.

It is the largest internal organ of the body. It performs several critical functions to help your body. It regulates most chemicals levels in the blood and excretes a product called bile. This carries away waste outputs from the liver. All the blood leaving the stomach and intestines passes through the liver.

Liver cancer is categorized as primary liver cancer – cancer that primarily starts from the liver; and secondary, if the cancer starts somewhere else and spreads to your liver.

According to the available statistics, primary liver cancer incidence rate with accordance to gender and age in India are estimated to be 4:1 ratio (male:female). The age presentation varies from 40 to 70 years. However, liver cancer can develop at any age in children as well as in adults.

Recent genome advancements have made it possible for prediction of liver cancers and understanding the risk percentage of liver cancer by analysing individual’s gene make up and family history.

Different Types of Liver Cancer

There are more than one kind of primary liver cancer. They are as listed below:

  • Hepatocellular carcinoma (HCC) – The most common type of cancer developed in adults.
  • Intrahepatic cholangiocarcinoma (bile duct cancer)
  • Angiosarcoma and hemangiosarcoma
  • Hepatoblastoma
  • Hemangioma
  • Hepatic adenoma
  • Focal nodular hyperplasia

Risk factors of Liver Cancer

Some individuals are at more risk of developing liver cancer than most. Here is a list of risk factors that influence your chance of developing liver cancer:

  • Age (mostly seen in people older than 60)
  • Gender (more likely in men than women)
  • Chronic viral hepatitis: Long-term infection with hepatitis B virus (HBV) or hepatitis C virus (HCV)
  • Cirrhosis: A late-stage liver disease where healthy liver tissue is damaged and replaced by scar tissue
  • Non-alcoholic fatty liver disease
  • Obesity
  • Excessive alcohol consumption
  • Tobacco usage
  • Type 2 diabetes
  • Environmental factors: Exposure to certain chemicals such as aflatoxin.
  • Family history of liver cancer
  • Inherited metabolic disease: Example – hereditary hemochromatosis can lead to cirrhosis

Common genes responsible for Liver Cancer

Some of the commonly associated genes with liver cancer are listed below:

  • HCCS gene
  • TP53 gene
  • CTNNB1 gene
  • MET gene
  • AXIN1 gene
  • CDKN2A gene

Assessment of Liver Cancer Risk

Assessment of cancer risk for liver cancer for those with high risk factors as mentioned above. Some of the tests an individual can take to know the possibility of cancer are:

  1. Detailed family history of liver and other cancers
  2. Personal history
  3. Screening options include: A combination of blood test called serum alpha fetoprotein (AFP) and liver ultrasound
  4. Relevant genetic testing for chromosomal abnormalities
  5. Other imaging tests include: computed tomography (CT or CAT) scan, or magnetic resonance imaging (MRI)

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FAQ's :

What is HCC? Is it hereditary?
HCC is Hepatocellular carcinoma, the most common form of liver cancer to be seen in adults. No, it is not passed on to next generations. However, one of the risk factors for developing is HCC is hereditary hemochromatosis, which has a genetic association.

 

Does liver cancer run in families?
Studies show that family history plays a role in developing liver cancer. If you have had a parent, sibling or child with liver cancer, the chances of you developing liver cancer are four times more likely than an individual without such a family history.
What is the role of environment in development of liver cancer?
Studies suggest the both genetic factors and shared environmental factors influence the risk of liver cancer. Apart from family history, hepatitis B or C infections increase the chance of a person of developing liver cancer.
How does genetic testing or screening tests help in the treatment of liver cancer?
When symptoms are observed, genetic testing or screening tests are recommended as they can help with early detection of cancer and this can provide better options of treatment or prevention.
What are the earliest symptoms of liver cancer?
Some of the early warning signs of liver cancer can be the following:
•   Sudden weight loss
•   Loss of appetite
•   Nausea and vomiting
•   Fatigue
•   Upper abdominal pain
•   White or chalky stools
•   Jaundice (Yellow discoloration of your skin and whites of your eyes)

References:

  1. What is Liver Cancer? https://www.cancer.org/cancer/liver-cancer/about/what-is-liver-cancer.html Accessed on 04-06-2022
  1. Liver Cancer. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/liver-cancer/symptoms-causes/syc-20353659 Accessed on 04-06-2022
  1. Liver Cancer Risk Factors. American Cancer Society. https://www.cancer.org/cancer/liver-cancer/causes-risks-prevention/risk-factors.html Accessed on 04-06-2022
  1. Liver Cancer: Risk Factors and Prevention. Cancer. Net. https://www.cancer.net/cancer-types/liver-cancer/risk-factors-and-prevention Accessed on 04-06-2022
  1. Family History of Liver Cancer. Hepatitis B Foundation. https://www.hepb.org/research-and-programs/liver/risk-factors-for-liver-cancer/family-history-of-liver-cancer/ Accessed on 04-06-2022

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