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A landmark report on the global prevention and control of liver cancer, led by Chinese experts and recently published in The Lancet, presents a new international roadmap to tackle a growing global health burden.
The report, titled "The Lancet Commission on addressing the global hepatocellular carcinoma burden: comprehensive strategies from prevention to treatment," was released on July 28, World Hepatitis Day.
It is the first time in over 200 years that The Lancet has published global health research led by Chinese experts. The study also involved contributions from 51 specialists across countries and regions such as Japan, the Republic of Korea, the United States and Spain, among others.
The Lancet Commission was co-chaired by Fan Jia, an academician of the Chinese Academy of Sciences. Speaking at a press conference in Zhongshan Hospital affiliated with Fudan University in Shanghai, Fan emphasized what distinguishes the study from typical academic reviews.
Unlike standard reviews or research articles, the report focuses on implementable public health strategies, said Fan.
Liver cancer, which is often referred to as a silent killer due to its long latency and subtle early symptoms, poses a serious challenge to global public health systems. The published report systematically reviews global practices, including China's experience, and covers topics such as epidemiology, risk factor control, early diagnosis, pathology, imaging, treatment strategies and medical ethics.
One key finding is the shifting pattern in liver cancer aetiology. While hepatitis B and C remain the dominant risk factors, cases linked to metabolic dysfunction-associated steatotic liver disease (MASLD) and alcohol consumption are on the rise. Unhealthy lifestyle habits such as high-sugar diets and lifestyles that lead to obesity are also reshaping the global liver cancer landscape.
Despite these challenges, the report estimates that about 60 percent of liver cancer cases are preventable. "China has accumulated valuable experience in prevention and control," said Zhou Jian, president of Zhongshan Hospital. "From hepatitis B vaccination and early screening to improvements in clinical care, our efforts show that liver cancer can be managed like other chronic diseases such as hypertension or diabetes."
To reduce new cases and deaths, the report proposes a three-tiered strategy.
First, prevention efforts should focus on expanding hepatitis B vaccination, promoting antiviral treatment for hepatitis B and C, and enhancing public awareness about the risks of unhealthy diets and alcohol.
Second, liver fibrosis screening should be integrated into health checks for high-risk groups such as people with diabetes or obesity, and there should be a broader adoption of non-invasive testing to improve accessibility.
Third, treatment systems should be strengthened by improving access to drugs, narrowing regional disparities, and incorporating palliative care at the start of treatment.
According to the report, liver cancer accounts for an estimated 870,000 new cancer cases and 760,000 deaths globally each year. If effective prevention measures are not taken, the global burden is projected to rise significantly, with new cases and deaths expected to reach 1.52 million and 1.37 million by 2050.
Modeling suggests that achieving an average annual reduction of at least 2 percent in age-standardized incidence rates is necessary to reverse this trend, potentially preventing 8.8 million new cases and 7.7 million deaths over the next 25 years.
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