You still get liver cancer after doing physical examinations every year, are you really doing it right?

Current status of liver cancer in China

High morbidity, low early diagnosis, high mortality

In 2020, the incidence of primary liver cancer (HCC) in China ranks the fifth among malignant tumors, with 410,000 new cases, accounting for about half of the number of new patients worldwide, and the second highest mortality rate of malignant tumors, with 391,000 deaths

Compared with the early diagnosis rate of liver cancer in China, which is 21.

The 5-year survival rate of liver cancer in China is only 14.

But in fact, tumors have been the first cause of death in Japan since 1981

From 2005 to 2010, the mortality rate of tumors under the age of 75 in Japan decreased year by year

Why is it difficult to detect early liver cancer?

Everyone knows that early detection is very important for cancer

Some patients with liver cancer said that I have a physical examination every year, why can't I find liver cancer?

Because the early symptoms of liver cancer are very unobvious

Many patients find it is advanced liver cancer until the tumor is so big that it supports their stomachs

In short, ordinary physical examination is difficult to detect early liver cancer

Japanese experience in early screening of liver cancer

In 1980, Japan launched a HCC screening program.

In 2002, the Japanese government funded liver cancer screening for HBV/HCV-infected patients over the age of 40, so that more than 60% of early liver cancers were detected

According to the survey, 72% of Japanese experts will use the "three items of liver cancer (AFP/AFP-L3%/DCP)" at the same time, and 44% of the experts will use the "three items of liver cancer" combined with liver ultrasound

Currently, three items of liver cancer have been included in the insurance applicable items in Japan

Difficult to find liver cancer in China

Where is the problem with early diagnosis?

Serum alpha-fetoprotein (AFP) is the most commonly used indicator for liver cancer screening.

At present, the routine screening program for liver cancer in China is: serum AFP + liver ultrasound testing; the commonly used screening program in Japan is: serum liver cancer three items (AFP/AFP-L3%/DCP) + liver ultrasound testing

Comparing the two, Japan’s screening program has two more serological indicators, AFP-L3% and DCP, than ours, which has increased the detection rate by nearly 40% compared with single-test AFP

More and more experts in our country are also aware of the importance of the three items of liver cancer
.

The "Guidelines for the Stratified Screening and Surveillance of Primary Liver Cancer (2020 Edition)", which guides liver cancer screening in China, pointed out that serum AFP combined with AFP-L3% and DCP detection can increase the detection rate of early liver cancer
.

The Guidelines for the Diagnosis and Treatment of Primary Liver Cancer (2019), which guides the diagnosis and treatment of liver cancer, also pointed out that serum alpha-fetoprotein heterogenes and abnormal thrombin can also be used as early diagnosis markers for liver cancer, especially for people with negative serum AFP
.

How to prevent liver cancer

In fact, there is a clear path for liver cancer prevention:

For people at high risk of liver cancer:

According to the "Guidelines for the Stratified Screening and Surveillance of Primary Liver Cancer (2020 Edition)" and the "Chinese Society of Clinical Oncology (CSCO) Guidelines for the Diagnosis and Treatment of Primary Liver Cancer 2020" [, the following high-risk groups of liver cancer should be conducted at least every 6 months 1 Inspections
.

Have hepatitis B virus (HBV) and/or hepatitis C virus (HCV) infection

Long-term drinking

Nonalcoholic steatohepatitis

Long-term consumption of food contaminated with aflatoxin

Cirrhosis of the liver caused by various other reasons

Metabolic-related fatty liver disease (MAFLD)

Diabetes, obesity, smoking, and drug-induced liver and liver injury

People with family history of liver cancer

Men over 35 years old, women 45 years old

The screening program refers to the latest "2021 Japanese Liver Association (JSH) Consensus Recommendations: Management of Hepatocellular Carcinoma (Updated Edition)" recommendations from Japan:

Very high-risk groups:

Ultrasound testing is performed every 3-4 months;

Tumor markers (AFP/DCP/AFP-L3%) are tested every 3-4 months

CT/MRI (optional) once every 6-12 months

High-risk groups:

Ultrasound testing is performed every 6 months;

Tumor markers (AFP/DCP/AFP-L3%) are tested every 6 months

Combining the Healthy China Initiative and referring to Japan’s experience, the three items of liver cancer (AFP/DCP/AFP-L3%) + liver ultrasound examination to screen for liver cancer are currently the most advanced and mature detection program, and it is also the most advanced and mature detection program that can increase the early diagnosis rate of liver cancer and reduce the mortality rate.
Effective means
.
Compared with treatment after the disease has occurred, prevention is not only effective, it can save more lives, and the cost is much lower than treatment
.