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HealthDay reporter
THURSDAY February 26, 2021 (HealthDay News) – Blacks with Hepatitis C develop liver cancer earlier than people belonging to other racial groups and Cancer is often more aggressive, but current screening guidelines may not be broad enough to detect these cases early, according to a new study.
Why? Although often more advanced, liver cancer in blacks is slower to cause liver damage and scarring, and current guidelines call for screening for liver cancer only after such scarring (cirrhosis) has occurred. , the researchers said.
“Not only is cancer more aggressive, but we also don’t detect it at the same time as in other populations,” said study author Dr Umut Sarpel, associate professor of surgery and training. medical at Icahn. Mount Sinai School of Medicine in New York. “Providers in this area say that as long as you don’t develop cirrhosis, you’re fine, but this study tells us that’s not really the case for everyone.”
As the rates of many other cancers decline, liver cancer is on the rise, according to the United States Centers for Disease Control and Prevention. Hepatitis C infection is the main risk factor for hepatocellular carcinoma (HCC), the most common type of liver cancer in adults. Hepatitis C can cause cirrhosis, which can lead to liver cancer.
Researchers reviewed the medical records of nearly 1,200 people with hepatitis C and liver cancer treated at Mount Sinai Medical Center. Of these, 390 were blacks.
By the time their liver cancer was diagnosed, black people had hepatitis C also had larger liver cancers with more aggressive features, but little or no scarring, Sarpel said.
Almost a third of black patients in the study would not qualify for liver cancer screening using routine cirrhosis measurements, she said.
It’s not yet clear exactly why tumors are more aggressive, but researchers are working on it. It could be related to genes, lifestyle or access to care, Sarpel said. Similar disparities have been seen in other cancers, including triple negative breast cancer, she said.
Continued
Current guidelines should be changed to catch liver cancer earlier, Sarpel said: “If you’re black and have hepatitis C, let’s not wait for cirrhosis to screen for liver cancer.”
Screening for liver cancer usually involves an ultrasound of the liver. “In the future, genetic markers or a blood test can help identify high-risk people earlier and get them screened earlier,” said Sarpel.
The results were published on February 25 in the journal Cancer.
The results have important implications for liver cancer screening in the black population, said Dr Mark Yarchoan. He is Assistant Professor of Medical Oncology at the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University in Baltimore.
“Current screening guidelines designed to catch early-stage liver cancer in patients with liver disease may lack liver cancer in a large number of black patients,” said Yarchoan, who was not involved in the new study.
Still, some questions remain, he said. “We don’t know if there is anything inherent in these liver cancers that make them more aggressive, or if the data reflects higher rates of other co-morbidities such as diabetes in this patient population, or whether these results reflect barriers to accessing health care, ”Yarchoan noted.
“Get to the bottom of” why? “will be critical to improving outcomes for black patients, and potentially for other liver cancer patients,” he said. Next, Yarchoan said, screening guidelines and cancer therapies can be further optimized for all patients at risk of liver cancer.
More information
Find out more about hepatitis C at United States Centers for Disease Control and Prevention.
SOURCES: Umut Sarpel, MD, associate professor, surgery and medical education, Icahn School of Medicine, Mount Sinai, New York City; Mark Yarchoan, MD, assistant professor, medical oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore; Cancer, 25 February 2021
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