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Hepatitis and liver cancer in Australia
The diagnosis of primary liver cancer (also known as hepatocellular carcinoma) related to chronic viral hepatitis infection in Australia is on the rise. In 2012, data from an AIHW report shows that primary liver cancer is the fastest increasing cause of cancer death and has the fastest increasing incidence of all cancers.1 Liver cancer survival remains low, with less than 16% of people still alive 5 years after diagnosis.2 In 2014 it was estimated that 1,615 people died of liver cancer, which is similar to the number of lives lost to melanoma (1,625), a much more common, but less lethal cancer. Aboriginal and Torres Strait Islanders are more likely to develop liver cancer than non-Indigenous Australians and are 2.5 times more likely to die from liver cancer.3
Globally, viral hepatitis is responsible for 80% of liver cancers. The majority of primary liver cancers are from untreated chronic hepatitis B or C infection.
There are over 240,000 people living in Australia with chronic hepatitis B infection.4 Most of these infections are in people from countries with a high prevalence of hepatitis B and were infected at birth or in childhood. Without medical intervention, up to 1 in 4 people living with chronic hepatitis B infection will die from liver cirrhosis or liver cancer.
There are about 230,000 people in Australia living with chronic hepatitis C infection.5 Most new infections are related to the sharing of injecting drug equipment. Around 20% of people remain undiagnosed.
There are new drugs available. These drugs can cure the hepatitis C virus in 95–97% of cases in as little as 8 weeks, and have few or no side effects. Between 60–70% of those with chronic infection will develop chronic liver disease, 20–30% will develop cirrhosis, and 1–5% will be diagnosed with liver cancer.
The Screening, Early Detection and Immunisation program works to address the rise of liver cancer caused by viral hepatitis. The program has a focus on reducing the number of people with hepatitis who are undiagnosed as well as increasing access to treatment and monitoring.
Quick facts hepatitis B
- 2 in 5 people are unaware that they have chronic hepatitis B and maybe symptom-less.
- The majority of people who need to be tested and treated are people from countries with a high and intermediate prevalence, and Aboriginal and Torres Strait Islander people.
- 15% of people with chronic hepatitis B would benefit from treatment. Less than 6% of those who need treatment are currently accessing it.
- Appropriate treatment for chronic hepatitis B can reduce the risk of liver cancer by up to 75%.
- Hepatitis B infection is vaccine preventable and many people are eligible for free vaccinations.
Quick facts hepatitis C
- 1 in 6 people are undiagnosed and may not have symptoms.
- People who need testing include those from priority groups.
- 60% of people with hepatitis C would benefit from treatment and up to 13–15% have accessed the new treatments in 2016.
- There is no vaccine for hepatitis C.
Early diagnosis is the key for liver cancer prevention
- People from priority populations for hepatitis B and C need to be tested.
- People need their liver health checked regularly and referral to a specialist at the right time – there is no such thing as a healthy carrier.
- People should be treated for hepatitis and screened for liver cancer at the right times.
- Priority populations need to be vaccinated for hepatitis B.
For more information on liver cancer, visit the liver cancer section on Cancer Council Victoria website. See this case study to learn more about increasing hepatitis B awareness amongst the South Sudanese community.
References
- https://www.mja.com.au/journal/2012/197/9/liver-cancer-fastest-increasing-cause-cancer-death-australians
- https://www.aihw.gov.au/reports/cancer/cancer-in-australia-2019/contents/summary
- https://www.aihw.gov.au/reports/cancer/cancer-in-indigenous-australians/data
- https://onlinelibrary.wiley.com/doi/full/10.1111/1753-6405.12049
- https://kirby.unsw.edu.au/news/sexually-transmissible-and-blood-borne-infections-australia-2013-surveillance-reports