07 Oct Global Liver Institute Urges Congress to Fund Fight Against Liver Cancer During COVID-19 Epidemic
MedicalResearch.com Interview with:
Donna R. Cryer, JD
President & CEO of the Global Liver Institute
MedicalResearch.com: What is the background for this announcement? What is the mission of the GLI?
Response: Global Liver Institute ‘s (GLI) mission is to improve the impact of the liver community by promoting innovation, collaboration, and scaling optimal approaches to eradicating liver diseases. Our vision is for liver health to take its proper place on the global public health agenda consistent with its prevalence and impact. One of the ways we seek to fulfill that mission is through a #OctoberIs4Livers worldwide awareness campaign for the fight against liver cancer, reinforcing October as liver disease and liver cancer awareness month. Not only are we seeing a continuous rise of prevalence of liver cancers, but survival rates for liver cancers are also some of the lowest of any cancer.
Even more concerning is that the startling truth about the rise of liver cancer rates began before the COVID-19 pandemic. With the added burden of COVID-19, patients directly at risk from the virus may be diagnosed at a later stage due to delayed screening, and are getting sicker due to limitations on access to care during this pandemic. GLI is appealing to the US Congress to act now to secure the health and well-being of people living with liver disease and liver cancers during COVID-19. Funding is crucial to ensure federal agencies can restart and continue medical research, implement targeted prevention, and support awareness efforts for those impacted by liver disease as they are at increased risk for severe illness from COVID-19. 
MedicalResearch.com: How large is the problem of liver disease/liver cancer? What are the primary underlying diseases?
Response: The American Cancer Society estimates more than 40,000 new cases of primary liver cancer (hepatocellular carcinoma [HCC] and intrahepatic cholangiocarcinoma [CCA]) will be diagnosed in 2020 and more than 30,000 people will die from the disease.  Approximately 85% of new liver cancer cases are HCC, making it the most common type of liver cancer.
Almost all new cases of hepatocellular carcinoma are diagnosed in people living with a chronic liver condition. The most common drivers of HCC include chronic infection with viral hepatitis – hepatitis B and C, Nonalcoholic Steatohepatitis (NASH), cirrhosis, or alcohol-related liver disease. [2,3,4]
New liver cancers are diagnosed most frequently in men from American Indian & Alaska Native, Hispanic, Asian and Pacific Islander, and Non-Hispanic Black communities with incidence rates nearly double that of men of all races. 
MedicalResearch.com: How has the COVID-19 impacted individuals impacted by liver cancer? How has it affected research into liver diseases?
Response: Unfortunately COVID-19 disproportionately impacts older adults and people of any age who have serious underlying medical conditions, including those with liver disease. This impact can be felt either directly due to the virus, or indirectly due to the pandemic’s impact on research and care.
We still lack a complete understanding of how COVID-19 impacts the liver. We do know that early research, highlighted by the Centers for Disease Control and Prevention (CDC), has found increased mortality rates from COVID-19 among people with chronic liver disease, liver cancer, and cirrhosis. Yet, due to the impact of the pandemic on our health system, the federal agencies like the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and the National Cancer Institute (NCI), lack the capacity to continue existing research projects and undertake new research on COVID-19 related comorbidities, including liver cancers and liver disease. Coupled with this, clinical trials have also struggled since the start of the pandemic. Initially many trials were halted and accrual was stopped, leaving patients with even fewer options for liver cancer treatment. This research is critical for not only disease mitigation and the development of effective treatments and vaccines, but also for us to understand how COVID-19 directly impacts liver health.
Outside of the direct impacts from the virus, the oncology community is bracing for a spike in new liver cancer cases due to the slowdown in crucial preventive measures like screening for liver cancer, which is recommended for those with cirrhosis and chronic Hepatitis B virus, and healthcare visits at the start of the COVID-19 pandemic. The CDC also reports that in the US alone, over 40% of adults have delayed or forgone medical treatment during the pandemic.  Even if oncology centers across the US are working tirelessly to ensure patients remain on their treatment protocols, clinical trials are recruiting and ongoing, and people with newly diagnosed liver cancer are evaluated quickly and effectively, patients are not receiving the care they need. This only underlines the point more that Congress must prioritize our public health infrastructure, and increase funding for vital medical research programs to ensure all patients impacted by liver cancer have access to the best treatment options and so that the disease does not progress.
MedicalResearch.com: Is there anything else you would like to add?
Response: Liver cancer won’t wait for COVID-19 to be over. Please learn more about our awareness efforts through the #OctoberIs4Livers campaign. Individuals and organizations can get involved by joining our social media campaign, watching a GLI Live on Facebook, perusing our Liver Cancer Lessons materials, or signing our global pledge to double to five-year-survival rate! Learn more at https://www.globalliver.org/octoberis4livers
- Centers for Disease Control and Prevention, People at Increased risk Coronavirus Disease 2019 (COVID-19) https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/index.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fneed-extra-precautions%2Fpeople-at-increased-risk.html
- American Cancer Society, Cancer Facts and Figures 2020. https://cancerstatisticscenter.cancer.org/#!/data-analysis/DeathRate
- Massoud O, Charlton M. Nonalcoholic fatty liver disease/nonalcoholic steatohepatitis and hepatocellular carcinoma. Clin Liver Dis. 2018;22(1):201-211.
- Pennisi G, Celsa C, Giammanco A, Spatola F, Petta S. The Burden of Hepatocellular Carcinoma in Non-Alcoholic Fatty Liver Disease: Screening Issue and Future Perspectives. Int J Mol Sci. 2019;20(22):5613. Published 2019 Nov 9. doi:10.3390/ijms20225613
- Cancer Statistics Center, American Cancer Society https://cancerstatisticscenter.cancer.org/#!/data-analysis/IncRate
- Journal of Hepatology https://www.journal-of-hepatology.eu/article/S0168-8278(20)30305-6/fulltext#%20
- Centers for Disease Control and Prevention https://www.cdc.gov/mmwr/volumes/69/wr/mm6936a4.htm?s_cid=mm6936a4_w&source=email
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