NSW Cancer Council: Liver Cancer Crisis Reversible

Australia has made impressive strides in reducing overall cancer mortality rates over the past two decades, with a decrease of approximately 25%. This notable achievement is largely attributable to advancements in prevention strategies, early detection methods, and improved treatment and care options. However, this positive trend does not extend to all types of cancers. Alarmingly, death rates from liver cancer have surged by over 40% during this same period. 

Why is such an increase occurring in a country renowned for its effective cancer control? Why isn't this alarming statistic making headlines? And importantly, how can we reverse this worrying trend? 

To understand these questions it's important to identify who are most affected by liver cancer – Australia’s most disadvantaged populations. The primary risk factors associated with liver cancer include hepatitis B and C infections; both bloodborne diseases that predominantly afflict low-income communities. 

Hepatitis B is widespread among many lower- and middle-income countries. Despite a vaccine being available since the early '80s in Australia, many people within disadvantaged communities remain unprotected due to infection or lack of accessibility. Similarly, Hepatitis C wasn’t discovered until the late '80s resulting in a spike of infections primarily linked to injectable drug use. 

Other significant contributors towards increased liver cancer risks include smoking habits, heavy alcohol consumption and increasingly prevalent fatty liver disease tied to obesity trends. These risk factors disproportionately impact migrant populations along with Aboriginal and Torres Strait Islander peoples - groups already facing considerable obstacles accessing healthcare services or advocating for their health rights. 

This situation presents three interconnected problems: persistent socio-economic disadvantage; unchecked preventable risk factors; as well as an expanding yet underrepresented patient demographic. 

However bleak this may seem there is hope on the horizon thanks to Cancer Council Australia's initiative which successfully secured funding from the Australian Government back in 2019 for developing the nation's first roadmap aimed at improving liver cancer outcomes. 

Under Professor Jacob George's guidance along with Dr Nicole Allard's expert input, the Daffodil Centre's Gastrointestinal Cancers stream developed this roadmap. The plan is based on evidence and supported by clinical practice guidelines that outline 26 key actions ranging from prevention to end-of-life care, in addition to identifying research priorities for driving future improvements in liver cancer control. 

While there are effective tests available for diagnosing hepatitis infections or detecting precancerous liver disease through blood tests and ultrasound examinations respectively, mass screening of average-risk populations isn't endorsed due to lack of supporting evidence. Hence, the focus should be on implementing targeted access strategies aimed at those most likely to benefit. 

This requires urgent research into practical ways of integrating this roadmap into healthcare systems which will necessitate funding support. Liver cancer represents a stark example of health inequity within Australia’s cancer outcomes – a challenge we must rise up against as a community if we hope to change our nation’s path with regards to this deadly disease.  

In conclusion, despite significant progress made in overall cancer management within Australia over the past two decades, liver cancer remains an alarming exception that needs urgent attention and action.