What are the risk factors for liver cancer

What are the risk factors for liver cancer

Incidence rates of hepatocellular cancer are rising in the United States due to increasing prevalence of cirrhosis caused by chronic hepatitis C and non-alcoholic fatty liver disease.

Cirrhosis of the liver due to any cause is a risk factor for liver cancer. The risk factors for liver cancer in cirrhosis are being male, age 55 years or older, Asian or Hispanic ethnicity, family history in a first-degree relative, obesity, hepatitis B and C, alcohol use, and elevated iron content in the blood.

Chronic hepatitis B infection even without cirrhosis is a risk factor for liver cancer.

What are liver cancer symptoms and signs

Liver cancer causes no symptoms of its own. As the tumor grows, it may cause symptoms of pain in the right side of the abdomen or a feeling of fullness when eating. Some patients may have worsening of symptoms of chronic liver disease or cirrhosis, which often precedes the development of cancer of the liver. For example, patients may complain of unexplained weight loss, wasting (cachexia), decreased appetite, increased swelling of the feet and belly, and yellowing of the eyes and skin (jaundice).

How is liver cancer diagnosed

The best way to detect liver cancer is through surveillance ultrasound of the liver done every six months in a patient with a diagnosis of cirrhosis and to treat the liver cancer as soon as it is detected.

Once a suspicion of liver cancer arises, a physician will order one the following

Blood tests: alfa-fetoprotein (AFP), which may be elevated in 70% of patients with liver cancer. AFP levels could be normal in liver cancer. A rising level of AFP is suspicious for liver cancer. Other labs tests include des-gamma-carboxy prothrombin, which can be elevated in most patients with liver cancer.

Imaging studies: Multiphasic helical CT scan and MRI with contrast of the liver are the preferred imaging for detecting the location and extent of blood supply to the cancer. If any imaging study is inconclusive, then an alternative imaging study or follow-up imaging study should be performed to help clarify the diagnosis. Lesions smaller than 1 cm are usually difficult to characterize.

Liver biopsy is performed to sample tissue from the lesion in the liver, which is analyzed by a pathologist to confirm the suspected diagnosis of liver cancer. Liver biopsy is not needed in every case, especially if the imaging study and lab markers are characteristic for liver cancer. Risks of liver biopsy are infection, bleeding, or seeding of the needle track with cancer. Seeding is when cancer cells get on the needle used for a biopsy and spread to other areas touched by the needle. Liver biopsy of suspected liver cancer carries the added risk of seeding the liver biopsy needle track in 1%-3% of cases. If a liver biopsy is inconclusive, then a repeat imaging study is recommended at three- to six-month intervals.

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Cancer risk for smokeless tobacco users

Cancer risk for smokeless tobacco users

Use of smokeless tobacco products is attracting increasing attention from the public health community. Though smokeless tobacco use is less common than cigarettes, it is prevalent among certain population groups, particularly men and young people.

The National Adult Tobacco Survey estimates that 7.1% of American men used chewing tobacco, snuff, dip, snus or dissolvable tobacco products in 2012-13.

Among US high school students, the National Youth Tobacco Survey (NYTS) found that 9.6% of males used chewing tobacco, snuff or dip and 2.7% used snus - a tobacco product that is put in the mouth - in 2013.

Since 2000, cigarette smoking prevalence has declined, but smokeless tobacco use among US youth has remained relatively consistent.

This is a cause for concern because it has been found to have several adverse health effects and has been identified as a cause of cancer.

Smokeless products known to contain carcinogens

Previous small studies have found high levels of toxic constituents, including carcinogens, in smokeless tobacco users, but more analysis of nationally representative data has been needed.

Lead author Brian Rostron, PhD, an epidemiologist in the Center for Tobacco Products at the US Food and Drug Administration (FDA), and colleagues examined data for 23,684 adult participants in the National Health and Nutrition and Examination Survey (NHANES) - a large, nationally representative study of US health behaviors and outcomes from 1999-2012.

They recorded participant-reported cigarette and smokeless tobacco use and categorized individuals into four groups: 16,313 non-tobacco users, 488 exclusive smokeless tobacco users, 6,791 exclusive cigarette smokers and 92 dual cigarette and smokeless tobacco users.

They analyzed biomarkers of exposure to seven tobacco constituents, including nicotine and tobacco-specific nitrosamine.

High levels of cotinine and NKK exposure in smokeless product use

The level of cotinine, the biomarker of nicotine exposure, was higher in exclusive smokeless tobacco users compared with exclusive cigarette smokers. The biomarker of NNK exposure was also higher in exclusive smokeless tobacco users compared with exclusive cigarette smokers.

The analysis confirms that levels of biomarkers of exposure to nicotine and the cancer-causing tobacco constituent NNK are higher among exclusive smokeless tobacco users than exclusive cigarette smokers. This continues to put smokeless tobacco users at risk for adverse health effects, including cancer.

Rostron says the findings confirm the need to continue studying of the toxic constituents of smokeless tobacco and their health effects on the individuals who use them.

The FDA and Centers for Disease Control and Prevention (CDC) are continuing to analyze and monitor biomarker levels among tobacco users.

In addition, the FDA and National Institutes of Health (NIH) are collaborating on the Population Assessment of Tobacco and Health (PATH) Study - a large longitudinal study that involves collection of biospecimens such as blood and urine.

Limitations of the current study include the nature of the data collected in NHANES. Being a general health survey, there is no detailed information on the type of smokeless tobacco product used, the quantity of smokeless tobacco product used and the duration or former use of smokeless tobacco products.

However, Rostron notes that the PATH Study data will allow for more specific analyses of tobacco use and harm.

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Will avoiding meat reduce risk of kidney cancer?

The incidence of renal cell carcinoma (RCC), the most common form of kidney cancer in adults, has been increasing in the US and other developed nations.

Previous studies have linked meat intake with an increased risk of RCC. The underlying mechanism for the association remains unclear, but cooking meat at high temperatures, particularly barbecuing or pan-frying, has been found to result in the formation and ingestion of carcinogenic compounds.

The kidney plays a significant role in the metabolism of xenobiotics, substances normally alien to the body, such as drugs, pesticides or carcinogens, and is therefore exposed to higher concentrations of cancer-causing substances than other organs.

Meat cooked at high temperatures produces carcinogens

A team led by Dr. Xifeng Wu, PhD, of the University of Texas MD Anderson Cancer Center in Houston, suspected that factors related to a Western lifestyle - such as a diet high in meats, processed foods and starches - may significantly impact the development of RCC.

They set out to investigate the effect of genetic factors and dietary intake of meat-cooking mutagens, such as MeIQx and PhIP, on RCC risk. An analysis was carried out of 659 patients with newly diagnosed RCC and 699 healthy controls.

Compared with cancer-free individuals, patients with kidney cancer were found to consume more red and white meat; they also consumed more cancer-causing chemicals, produced by cooking meat at high temperatures or over an open flame, particularly when pan-frying or barbecuing.

People with RCC were also found to have an overall higher daily total energy intake and lower overall total fruit and vegetable intake.

Fast facts about kidney cancer

In 2005, more than 36,000 people were diagnosed with kidney cancer in the US

In 2014, there were over 50,000 diagnoses

There are currently 200,000 kidney cancer survivors in the US.

Learn more about kidney cancer

Ingestion of MelQx would seem to nearly double the risk of RCC, and intake of PhIP increases it by 54%. This suggests that eating meat cooked at high temperatures increases the risk of RCC through mechanisms related to mutagenic cooking compounds.

A significant interaction was noted between PhIP and at least one genetic feature, implying that individuals with certain genetic variants are more susceptible to the harmful effects of these cancer-causing chemicals.

Limitations of the current study include the possibility of residual confounding by unknown risk factors and the difficulty of isolating the impacts of the mutagenic compounds, due to the complex interaction of individual components and nutrients in whole foods.

Nevertheless, the findings suggest that reducing meat consumption, especially when cooked at high temperatures or over an open flame, could serve as a public health intervention to reduce the risk of developing RCC. In addition, genetic testing might help to identify individuals at especially high risk.

Medical News Today recently published findings linking a drug commonly used for heartburn with kidney cancer.

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