Liver cancer in Singapore

In Singapore, primary liver cancer, also known as hepatocellular carcinoma (HCC) is the third most common cause of cancer deaths amongst males and fourth most common amongst females1.

While there are a number of causes, the main risk factors for the disease are well defined. It is possible to prevent liver cancer by reducing exposure to risk factors and making lifestyle changes.

How to prevent liver cancer

1. Vaccinate against hepatitis B

“The most significant risks for liver cancer are chronic infection with hepatitis B virus and hepatitis C virus. These viruses can spread through body fluids (e.g. through the use of contaminated needles or unprotected sex),” explains Professor Pierce Chow, Senior Consultant from the Division of Surgery and Surgical Oncology at Singapore General Hospital (SGH) and National Cancer Centre Singapore (NCCS). Both SGH and NCCS are members of the SingHealth group.

In many parts of Asia, however, hepatitis B is endemic in the population and many patients are infected with hepatitis B through vertical transmission, i.e. transmitted from mother to child during childbirth.

While there is no vaccine currently available for hepatitis C, there are very good and safe vaccines for hepatitis B. Children and adults are strongly advised to be vaccinated for hepatitis B. especially if they live in parts of the world where hepatitis B is endemic.

2. Avoid high-risk behaviours

As viral hepatitis B and C are spread through bodily fluids, high-risk behaviours that increase spread of the diseases should be avoided. This includes using contaminated needles and unprotected sex, other than with a regular partner.

3. Avoid excessive alcohol consumption

Another significant risk factor for liver cancer is liver cirrhosis which can be caused by excessive alcohol consumption. Limiting the consumption of alcohol can prevent liver cancer.

Health Promotion Board (HPB) recommends no more than two standard drinks a day for men, and no more than one standard drink a day for women. A standard alcoholic drink is defined as a can (330 ml) of regular beer, half a glass (100 ml) of wine or 1 nip (30 ml) of spirit.

4. Maintain a healthy weight and active lifestyle to prevent fatty liver

Maintaining a healthy weight is key to overall better health outcomes. As it stands, in addition to hepatitis B and C, major risk factors for liver cancer are non-alcoholic fatty liver disease (NAFLD), non-alcoholic steatohepatitis (NASH) and diabetes. People who are overweight or obese are more likely to have these diseases, which makes maintaining a healthy weight essential.

5. Treat viral hepatitis

If you at risk for hepatitis B virus and hepatitis C virus, it is advisable to get tested. If positive, there are treatments for hepatitis B and hepatitis C, which can lower the risk of liver cancer. Individuals at risk will also be put on a regular screening schedule for liver cancer.

“While some patients will unfortunately be infected with chronic viral hepatitis, studies have consistently shown that treatment and control of these diseases can significantly decrease the risk of developing hepatocellular carcinoma (HCC). Currently, there is therapy available that can effectively eradicate hepatitis C and control hepatitis B,” adds Prof Chow.

Take charge of your health

The steps above outline different ways to minimise risk of liver cancer. Regular screening of liver cancer for those at high risk remains the best way to treat the disease, as early-stage detection of liver cancer is the best way to ensure the best outcomes.

Take part in the study to screen for liver cancer

A study led by Professor Pierce Chow at National Cancer Centre Singapore (NCCS) is looking for patients with chronic liver disease to take part in its research on liver cancer. For more information, click here.

1 National Registry of Diseases Office. (2021, March). Singapore Cancer Registry Annual Report 2018

Ref: K21

Check out other articles on liver conditions:

Liver Cancer: Risk Factors, Symptoms and Treatment

Liver Cirrhosis (Liver Scarring): Causes, Symptoms and Prevention

Liver Inflammation: What Causes It and How to Prevent

Fat Buildup in the Liver: Why It's Bad for You

Fatty Liver Disease: How to Reverse It

10 Ways to Keep Your Liver Healthy