Liver cancer: nature and risk factors
The liver is a large organ, occupying the upper right portion of the abdomen, which performs: 1. Production of bile which is needed for the digestion of fat in the intestine 2. Protein synthesis 3. Storage of glucose and fat 4. Breakdown of toxic substances such as alcohol
Liver cancer is a tumor that initially forms in the tissue of the liver.
There are different types of liver cancer according to the type of cancerous cells.
Hepatocellular carcinoma (HCC) is the most frequent type of primary liver cancer (85-90%). HCC begins in hepatocytes - the main cells of the liver.
Liver cancer can form many nodules within the liver and also spread into the blood vessels and other organs. These features make it difficult to perform a surgery treatment.
Liver cancer is not infectious.
Liver cancer is a global problem because this is the 2d leading cause (9,1%) of cancer deaths worldwide.
Liver cancer in Cambodia is on the 1st place among all malignant tumors according incidence (2,264 new cases in 2012, 14,9%).
In Cambodia liver cancer incidence and mortality are higher than worldwide and total amount of liver cancer patients is increasing every year [GLOBOCAN 2012: http://globocan.iarc.fr/].
Liver cancer can occur in adults and also in children and adolescents.
Risk factors of liver cancer are:
1. Chronic infection with hepatitis-B virus (HBV) and / or hepatitis-C virus (HCV): worldwide HBV infection is responsible for 50% and HCV infection for 25% of all cases of liver cancers. The risk of an individual with chronic HBV infection developing liver cancer is 100-fold that of an uninfected individual, for HCV infection the risk 17-fold. Co-infection (both viruses - HBV and HCV - in the same time) increases the risk. Long-term alcohol abuse (accounts for 10% liver cancers in Asia)
2. Chronic liver diseases with liver cirrhosis: 1/3 of these patients will develop liver cancer. A person with liver cirrhosis is 40 times more likely to develop liver cancer than a person with a normal liver.
3. Intake of aflatoxins-contaminated food.
Aflatoxin is a toxic substance produced by fungi (Aspergillus flavus, Aspergillus parasiticus) that can grow in food (rice, peanuts, ground nuts, soybeans, corn and flour) when stored in warm, damp condition and became moldy.
4. Male gender: liver cancer is four to eight times more common in men compared with women
5. Protein - deficiency, transferred in early childhood
6. Prevalence of dietary carbohydrates
7. Obesity
8. Diabetes
9. Gallstones
10. High parasitic invasion of biliary tract (opisthorchosis, clonorchosis, shistozomatozis)
11. Cigarette smoking
12. HIV infection
13. Long-term use of anabolic steroids.
People who are at risk for liver cancer:
1. People aged 50-60 years,
2. People with chronic viral hepatitis B and/or C,
3. People with different kinds of liver cirrhosis,
4. People with excessive alcohol consumption,
5. People who use a lot of dietary carbohydrates,
6. People with obesity and with diabetes:
Many liver cancers can be prevented by public health measures that reduce exposure of known risk factors.
