LONDON, July 29: Liver cancer is poised to become a significantly larger global health challenge, particularly affecting younger adults, with cases expected to double by 2050, experts warn. Previously viewed mainly as a disease impacting older individuals with hepatitis infections or alcohol dependency, liver cancer is increasingly being diagnosed in people in their 30s and 40s.

A major new analysis published in The Lancet attributes this shift to the rise in obesity and related liver conditions such as metabolic dysfunction-associated steatotic liver disease (MASLD). The report predicts new liver cancer cases worldwide will increase from 870,000 in 2022 to 1.52 million by 2050, with annual deaths rising from 760,000 to 1.37 million during the same period.

One of the fastest-growing causes is metabolic dysfunction-associated steatohepatitis (MASH), a severe form of fatty liver disease linked to obesity and metabolic dysfunction. The proportion of liver cancers connected to MASH is expected to more than double — from 5% in 2022 to 11% in 2050.

Cases caused by the most common causes of liver cancer — the hepatitis B and C viruses—are predicted to decline. However, cases related to obesity and alcohol consumption are expected to increase. By 2050, over a fifth of liver cancer cases will be attributed to alcohol, while one in ten will be caused by severe MASLD, formerly known as fatty liver disease. This condition occurs when fat accumulates in the liver and is closely associated with obesity and type 2 diabetes.

Researchers from Hong Kong emphasized that 60% of liver cancer cases are preventable. Their findings underscore the urgent need for preventative measures against liver cancer, also called hepatocellular carcinoma. The primary treatment for MASLD involves maintaining a balanced diet, engaging in physical activity, and potentially losing weight.

"Liver cancer is a growing health issue worldwide," said Professor Jian Zhou, chairman of the Commission from Fudan University in China. "It is one of the most challenging cancers to treat, with five-year survival rates ranging from about 5% to 30%. Without urgent action, we risk nearly doubling the number of cases and deaths over the next 25 years."

Professor Stephen Chan, lead author of the study from the Chinese University of Hong Kong, added: "There is a significant opportunity for countries to target these risk factors, prevent liver cancer cases, and save lives."

Pamela Healy, chief executive of the British Liver Trust, commented on the study: "Liver cancer is the fastest-rising cause of cancer death in the UK, with only 13% of people diagnosed surviving for five years or more. The main risk factors are pre-existing liver cirrhosis or viral hepatitis, and this analysis highlights that MASLD, also known as fatty liver disease, is linked to an increasing number of cases."

Liver cirrhosis is a progressive condition that can lead to liver failure if untreated, characterized by permanent scarring due to long-term damage. "Along with improving early detection through monitoring those with cirrhosis, it is vital to address the underlying causes and prioritize public health efforts," Healy said. "By helping people maintain a healthy weight, reduce alcohol intake, and get tested and treated for hepatitis, many liver cancer cases can be prevented."

In the UK, there is growing urgency to tackle the obesity crisis to ease pressure on the National Health Service. Recent data shows nearly two-thirds of adults in England are overweight, with an additional 260,000 people joining this group last year. Meanwhile, more than a quarter (26.5%)—about 14 million people—are classified as obese.

Last month, GPs were authorized to prescribe weight loss injections, known as GLP-1s, for the first time to address the crisis. Approximately 1.5 million people are currently using these injections through the NHS or private clinics, with millions more eligible. However, pharmacists have warned that the rising demand may become unsustainable.