Americans' death rates from cancer are going down. They've dropped 1.1 percent each year from 1993 to 2002, according to a recent Journal of the National Cancer Institute report. However, a fairly rare malignancy -- liver cancer -- is bucking the overall trend and now becoming more common.

"It's a concern worldwide," said Brenda Edwards of the National Cancer Institute, who cowrote the report. For liver cancer, researchers found annual increases of:

• 5 percent among Hispanic women
• 4.5 percent among black men
• 3.7 percent among white women
• 3 percent among white men

"It is not clear what's spurring the rise; one factor may be hepatitis infections," says Edwards, referring to the hepatitis virus that is sometimes a precursor to liver cancer.

Liver Cancer: Facts and Causes

The American Cancer Society estimates that 17,550 new cases of primary liver cancer and bile duct (tubes that carry bile to the gallbladder) cancer will be diagnosed in the United States during 2005. About 15,420 will die of the disease this year.

The disease is much more common in developing countries in Africa and in East Asia than it is in the United States. In fact, it is the most common type of cancer in many of these countries.

Scientists have identified several risk factors for the disease:

1. Gender:
   Men are twice as likely to get liver cancer than women, possibly because they may engage in more of the behaviors listed below.

2. Liver disease:
   Chronic infection with hepatitis B virus (HBV) and hepatitis C virus (HCV) increase liver cancer risk, as do some inherited liver diseases.

3. Cirrhosis:
   Scar tissue in the liver results in cirrhosis, which often leads to cancer. In the United States, the major causes of cirrhosis are alcohol abuse and hepatitis B and C, although too much iron in the liver can also cause it.

4. Smoking:
   Tobacco use has been linked to liver cancer, and the risk may increase further for people who also abuse alcohol.

5. Obesity:
   Obesity increases the risk of dying from liver cancer.

6. Aflatoxins:
   These are cancer-causing substances found in fungus that can contaminate peanuts, wheat, soybeans, groundnuts, corn and rice. Long-term exposure to aflatoxins can increase the risk of liver cancer. The United States and Europe tests foods for aflatoxin levels.

7. Vinyl chloride and thorium dioxide (Thorotrast):
   Exposure to these chemicals has been linked to several types of liver cancer. Thorotrast is no longer used.

8. Anabolic steroids:
   Long-term use of these male hormones (as used by some athletes to increase strength) is linked to a slight increase in liver cancer risk.

9. Arsenic:
   Drinking arsenic-contaminated water increases the risk of liver cancer.

10. Birth control pills:
    Birth control pills may slightly increase the risk of liver cancer. Most of the studies involved a type of pill that is no longer used, however, and it is not known if the type used today increases the risk.

11. Family history:
    Those with a family history of liver cancer may have a higher risk of getting the disease.

12. Age:
    Liver cancer is most likely to occur in people over the age of 60.

Best Approaches to Prevent Liver Cancer

Sadly, primary liver cancer has a high mortality rate, but there are ways to lessen your risk. One of the best ways to prevent this disease is to avoid infection with hepatitis B or C virus (In the United States, there is a vaccine for hepatitis B).

These viruses are spread by contaminated blood transfusions, contaminated needles of intravenous drug users and unprotected sex. Avoiding these behaviors will reduce your risk. Mothers can also pass the virus to children during birth or in early infancy.

Lots of raw fruits and vegetables can help keep your liver healthy.

Other methods for prevention of liver cancer include:
1. Limiting alcohol intake (and not abusing alcohol)
2. Quitting smoking
3. Avoiding foods that may have been contaminated with aflatoxin, particularly certain grains in developing countries, which
4. Avoid exposure to chemicals as much as possible
5. Eat a healthy diet, including the foods below

According to Sandra Cabot, MD, author of "
The Liver Cleansing Diet," the following dietary principles are vital for keeping your liver healthy:

1. Eat lots of raw fruits and vegetables, especially dark green leafy vegetables, bitter greens, cruciferous vegetables and orange yellow, purple and red-colored fruits and vegetables

2. Eat good fats that contain essential fatty acids, found in cold-pressed vegetable and seed oils, avocados, fish, raw fresh nuts and seeds, and legumes

3. Avoid bad fats (like hydrogenated fats), found in foods like margarines, processed vegetable oils, deep-fried foods, foods that contain rancid fats, preserved meats, animal skins and fatty meats

4. Avoid artificial chemicals (pesticides), artificial sweeteners and colorings, flavorings and preservatives

5. Avoid excess alcohol, particularly spirits
6. Avoid refined white sugar, candies, fizzy drinks, cakes, etc.
7. Drink large amounts of fluids such as water, raw juices and teas
8. Eat organic foods as much as possible (fewer insecticides, fungicides, etc.)

Recommended Reading

Six Disease-Fighting Super Antioxidants You are Likely Not Getting Enough Of

Cadmium Poisoning, Which Can Harm Your Kidneys and Reduce Your Bone Density, Surprisingly High

Sources

Journal of the National Cancer Institute October 5, 2005; 97(19):1407-27

Advoacate.com October 6, 2005

National Cancer Institute

American Cancer Society

Sandra Cabot's Liver Doctor Web site