AILSA CHANG, HOST:
The third leading cause of cancer death is liver cancer and preventing it could come down to some pretty basic lifestyle changes. A new study from the Lancet Commission on liver cancer says that 3 out of 5 cases of this disease are preventable. In fact, the best way to protect yourself is to get a hepatitis vaccine, control your weight or drink less alcohol. The commission estimates that these practices could reduce liver cancer cases by 2- to 5% each year by 2050, saving anywhere from 8 million to 15 million lives. One of the commission's authors is Hashem El-Serag from the Baylor College of Medicine in Houston. He joins us now. Welcome.
HASHEM EL-SERAG: Thanks for having me.
CHANG: Getting hepatitis vaccines and drinking less alcohol, those feel like obvious decisions to have a healthier liver but explain why weight control is important here when it comes to liver health.
EL-SERAG: The world in general - and the U.S. specifically - is undergoing through an epidemic of a condition called MASLD, Metabolic Dysfunction-Associated Steatotic Liver Disease, colloquially known as fatty liver. It's a condition that affects anywhere from a quarter to 30% of all adults in this country. And this condition is tightly linked to overweight, obesity, diabetes and unhealthy eating practices.
CHANG: And a fatty liver has a link to cancer risk, yes?
EL-SERAG: Indeed. Twenty to 30% of those with fatty liver, their liver would progress to more severe damage that can eventually lead to the condition known as cirrhosis, which is a badly damaged liver, and that serves as the precursor entity that predisposes people to a great degree to the development of liver cancer.
CHANG: Right. OK, well, can you explain how liver cancer treatment compares to the treatment of other cancers? Like, why might it be especially important to be proactive in detecting liver cancer?
EL-SERAG: The curative treatments for liver cancer are liver transplant, which is very difficult to conduct, or a surgical resection, meaning removal that part of the liver that is cancerous. And unfortunately, because most people who develop liver cancer have cirrhosis...
CHANG: Yeah.
EL-SERAG: ...Removal of that part of the diseased liver is not an option. All of these make the case for prevention as the most viable and feasible way of reducing this deadly cancer.
CHANG: And I'm curious - where in the world are you seeing the highest rates where liver cancer is caused by obesity or drinking alcohol?
EL-SERAG: There are two things happening at the same time. Despite the unevenness of prevention of hepatitis C and B, there is a global decline in the prevalence of both of these infections. At the same time, there's been a global increase in obesity, fatty liver and alcohol intake. So that would be North America - the U.S. specifically - and several parts of Western Europe and Australia. But the global obesity epidemic is exactly what it is. It's all over the world. But where it drives the liver cancer are the countries that I just specified.
CHANG: Because obesity is one of the potential causes of liver cancer, did your team look at the importance of drugs like Ozempic and other weight loss medications?
EL-SERAG: Yes. So the newer medications have been shown in multiple studies to reduce and maintain the weight loss related to their use, improve and sometimes even cure diabetes, reduce cardiovascular risk. But in the case of the liver, they have been shown to essentially cure MASLD, which is fatty liver. They reverse the amount of fat in the liver. They remove it, and they've been associated with a reversal in the degree of scarring in the liver. There is optimism and, indeed, early studies linking the use of these medications with a lower risk of cirrhosis and a lower risk of liver cancer.
CHANG: That is Hashem El-Serag from the Baylor College of Medicine. Thank you very much for your time today.
EL-SERAG: Thank you. Thanks for having me. Transcript provided by NPR, Copyright NPR.
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