MANILA, Philippines – If not prevented now, the number of deaths due to liver cancer will be twice the current average of 20 Filipinos a day 20 years from now, Dr Samuel So of Stanford’s Asian Liver Center said on World Cancer Day, February 4.

This projection is based on latest estimates of the International Agency for Research on Cancer (IARC) for the Philippines. So said that liver cancer is the 3rd leading cause of cancer deaths in the country, the 2nd among Filipino men, and the 5th among women. 

It is among the deadliest cancers in the world with a mortality to incidence ratio of 0.95. This means that for every 100 people who develop liver cancer, 95 have high chances of dying due to the disease. In 2012 alone, about 746,000 deaths were recorded worldwide. 

But the harsher truth is that liver cancer can actually be prevented.

Leading cause

Globally, the leading cause of liver cancer is infection due to the Hepatitis B virus (HBV) which accounts for 53% of primary liver cancer cases.

Symptoms of Hepatitis B infection include fatigue, loss of appetite, dark urine, yellow discoloration of the eyes, and even death from liver failure, but initially, patients may not be able to detect immediately that they are infected.

“The global burden of Hepatitis B and C is alarming because there are about 500 million globally who are chronically infected – 350 million by Hepatitis B,” Dr John Juliard Go, World Health Organization (WHO) representative in the Philippines, said during the Philippine Hepatitis & Liver Cancer Summit on Tuesday.

As of 2010, there are about 1.4 million deaths from Hepatitis B and C infection, including acute infections and those that result in liver cancer.

Transmitted in 3 ways (through birth, blood, or unprotected sex), So said most people in the Western Pacific Region – including Filipinos – become chronically infected by Hepatitis B through mother-to-child transmission and contact with infected blood.

80%-90% of infants develop chronic infections during the first year of life, according to Go, but it can be prevented by immunization – a major strategy and one of WHO’s “best buys” or cost-effective interventions to prevent and control non-communicable diseases like liver cancer. (READ: FAQ: PhilHealth’s Z benefit package)

Missed opportunities

In the Philippines, the law requires that all infants be given the birth dose of Hepatitis B vaccine within 24 hours, and two other shots after 6 and 14 weeks, respectively.

But access to the birth dose remains a challenge since 40% of birth deliveries are still being done at home, National Scientist and Ramon Magsaysay Awardee Dr Ernesto Domingo said.

This creates missed opportunities according to the health department, since only a few skilled birth attendants who assist home deliveries actually bring with them Hepatitis B vaccines.

“We want that all births should take place in a birthing facility run by a professional health care worker,” Domingo said.

He also quoted Health Secretary Enrique Ona as saying the challenge in the Philippines now is how to deliver immunization to every newborn in the country, and not the budget to procure the shots.

On the eve of World Cancer Day, the IARC, the specialized cancer agency of WHO, emphasized in a press release the urgency of using effective prevention measures like immunization to prevent a cancer crisis.

In a report released Monday, February 3, the IARC said cancer deaths will likely rise from 8.2 million to 13 million per year, “yet about half of all cancers could be avoided” through prevention, early detection and treatment. (READ: Cancer cases set to rise by half by 2030 – UN)  – Rappler.com