Liver Cancer on the Rise

Liver cancer is one of the world's most common types of cancer, and one of the most deadly. Worldwide prevalence is highest in southeast Asia and sub-Saharan Africa, but it has recently struck Japan particularly hard. The number of deaths from liver cancer in Japan increased steadily from about 10,000 in 1975 to 35,000 in 2002 because of an epidemic of hepatocellular carcinoma (HCC). This disorder, which accounts for 80% to 90% of all cases of liver cancer, is now the third most common cause of cancer death among Japanese men and the fifth most common cause among Japanese women.

In an expansive effort to reduce the toll, the Japanese health care system has focused valuable resources on HCC, and many physicians in Japan have devoted their careers to understanding the disease and exploring new treatments.

By comparison, HCC has received little attention in the United States because it is relatively uncommon (it is the 20th most common type of cancer). But that is changing. Today, it is the most rapidly increasing type of cancer in America—as in Japan, it is primarily caused by cirrhosis due to chronic hepatitis C virus (HCV) infection—and is the eighth leading cause of cancer death.

The rapid emergence of HCC in the United States has prompted a new consideration of liver cancer screening while also spurring a search for effective treatments and an HCV vaccine. Doctors here are looking to other countries for guidance, and Japan's experience with studying and caring for patients with HCC is proving instructive. The 2 countries currently deal with HCC in different ways, but they are starting to collaborate and converge on common policies—for example, they recently shared information at a 3-day National Institutes of Health workshop on HCC screening, diagnosis, and management. Later this year, the Japan Society …