Achieving Health Equity in Liver Cancer

Oct 1, 2021 | Oncology

Primary liver cancer death rates vary by region, and much is still to be done in the area of health equity.

Primary liver cancer is a leading cause of cancer-related illness and death worldwide. It is the sixth most-common cancer and the third most-common cause of death from cancer globally.1 Primary liver cancer includes hepatocellular carcinoma (HCC) (75%-85% of primary liver cancers) and intrahepatic cholangiocarcinoma or bile duct cancer (10%-15% of primary liver cancers). The major risk factors for liver cancer include chronic infection with the hepatitis B virus or hepatitis C virus, alcohol-induced liver disease, and nonalcoholic fatty liver disease. Globally, more than half of liver cancers are caused by chronic viral hepatitis B or hepatitis C virus infections.2 These infections are most common in Asia and Africa. In sub-Saharan Africa, including West Africa, approximately 3% to 12% of the population have chronic viral hepatitis, primarily hepatitis B.3 In these regions, liver cancer is typically the first or second most common cause of death from cancer in men and the third to fifth most common cause of death from cancer in women.1
In Asia and Africa, liver cancer often develops in younger individuals. Study results have shown that in most countries in sub-Saharan Africa, the average age of development of liver cancer is between 40 and 45 years.4
In West African countries such as Nigeria, Ghana, Senegal, and Gambia, the high incidence of death from primary liver cancer occurs in part due to the coinciding of risk factors with disparities in diagnosis and care of patients with liver cancer.


1. Sung H, Ferlay J, Siegel RL, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021;71(3):209-249. doi:10.3322/caac.21660

2. Thomas London W, Petrick JL, McGlynn KA. Liver cancer. In: Thun M, Linet MS, Cerhan JR, Haiman CA, Schottenfeld D, eds. Cancer Epidemiology and Prevention, 4th ed. Oxford University Press; 2018:635-660

3. Polaris Observatory Collaborators. Global prevalence, treat-ment, and prevention of hepatitis B virus infection in 2016: a modelling study. Lancet Gastroenterol Hepatol. 2018;3(6):383-403. doi: 10.1016/S2468-1253(18)30056-6

4. Yang JD, Gyedu A, Afihene MY, et al; Africa Network for Gastroin-testinal and Liver Diseases. Hepatocellular carcinoma occurs at an earlier age in Africans, particularly in association with chronic hepatitis B. Am J Gastroenterol. 2015;110(11):1629-1631. doi:10.1038/ajg.2015.289