Multimillion Dollar NIH Grant Funds YSPH Research on Liver Cancer

While liver cancer remains relatively uncommon in the United States, its incidence has been steadily increasing and for those afflicted with the disease the prospects for survival are grim.

In what is believed to be the first population-based study of its type in the United States, a Yale School of Public Health research team will examine the genetic and environmental factors associated with the deadly disease, which is also known as hepatocellular carcinoma. The multiyear study is funded with a $6.98 million grant from the National Cancer Institute.

The incidence of liver cancer in the United States has nearly doubled since 1980 and there is evidence that factors such as infection with hepatitis viruses, especially hepatitis C virus, obesity, and alcohol consumption are contributing to the increase, said Herbert Yu, an associate professor at the School of Public Health and the study’s principal investigator.

“There are indications that lifestyle factors, such as being overweight and physical inactivity, may be especially important in contributing to the dramatic increase in liver cancer incidence. This could have broad implications in public health because these lifestyles are increasingly prevalent in our society,” he said. “If the link between lifestyle and liver cancer risk is true, then more people will face this devastating disease in the future if we do not change our lifestyle on diet and physical exercise.”

The study is in its early phases to enroll about 1,200 people with liver cancer in Connecticut and New Jersey and 2,500 randomly selected people who do not have the disease to serve as controls. A genomewide analysis of nucleic acids will be done on study participants in an effort to pinpoint the disease’s genetic underpinnings. Lifestyle factors will also be examined to gauge their role in the onset of the cancer, Yu said.

A better understanding of the biological origins and contributing environmental factors could allow health care professionals in the future to effectively screen people at heightened risk for the disease and for people who are at risk to take preventive measures before the disease develops.

Liver cancers afflict about six people per 100,000 in the United States, which translates into about 21,000 new cases annually, Yu said. Men are more than twice as likely as women to be diagnosed and most people with the disease are usually older, often in their sixties. The rate of liver cancer is far higher in developing regions of the world such as Africa and Asia, where as many as 100 people per 100,000 are affected. The five-year survival rate for those with liver cancer is less than 10 percent.

Yu has investigated several types of cancer during his career, including breast, ovarian, prostate and endometrial cancers. He has also previously studied liver cancer in his native China, primarily looking at factors such as food and drinking water contaminated with fungi, pesticides and chemical fertilizers. Yu will be joined by several colleagues at the Schools of Public Health and Medicine on the current research study, including Harvey Risch, Susan Mayne, Melinda Irwin, Hongyu Zhao, Xiaomei Ma and Joseph Lim. The Yale Cancer Center and the Yale Liver Disease Center will also participate.