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A startling 60% of liver cancer cases worldwide stem from preventable causes, according to a new Lancet report, with obesity-related liver disease emerging as one of the fastest-growing drivers of the illness. Published on July 29, the analysis underscores an alarming projection: without swift intervention, annual liver cancer diagnoses could nearly double to 1.52 million by 2050, while deaths may surge from 760,000 to 1.37 million in the same timeframe.

The study pinpoints three modifiable risks—viral hepatitis, alcohol abuse, and metabolic dysfunction-associated steatotic liver disease (MASLD), often linked to obesity—as central to reversing this trajectory. Of particular concern is the rapid rise of MASLD, a condition involving excessive liver fat, with its severe form (MASH) projected to increase liver cancer cases by 35% globally over the next 26 years. In the U.S., over half of adults may develop MASLD by 2040, while African nations face a dual crisis of historical and emerging threats.

“Liver cancer isn’t being prioritized proportionally to its burden,” said Professor Hashem El-Serag, a Baylor College of Medicine hepatologist and co-author of the Lancet Commission report. While hepatitis B and C cases are declining slowly due to improved vaccines and treatments, he notes, “the obesity-driven tide is rising faster than health systems are adapting.”

Africa exemplifies this collision of risks. Despite progress against hepatitis, inadequate screening and vaccination programs persist, leaving millions vulnerable. Simultaneously, dietary shifts tied to globalization—including increased consumption of sugary drinks and processed foods—are fueling metabolic disorders. Dr. Lilian Kalebi, a pathologist consulting for the report, observes that in some communities, a “pot belly” remains culturally associated with prosperity, masking its health risks.

“Metabolic diseases are becoming a poor man’s burden,” Kalebi explained. “Cheap, calorie-dense foods like sodas and refined carbs are displacing traditional diets, particularly in rural areas. There’s a tragic irony—what was once seen as a marker of wealth now drives preventable illness among the economically disadvantaged.”

The Lancet Commission outlines urgent measures: scaling up hepatitis B immunization, enforcing stricter alcohol controls, and prioritizing liver health screenings for high-risk groups like those with diabetes or obesity. Researchers calculate that reducing liver cancer rates by just 2-5% annually could prevent up to 17 million cases and 15 million deaths by midcentury.

Treatment gaps remain stark. Less than 30% of liver cancer patients globally receive potentially curative therapies, while palliative care access remains limited—a disparity the report urges governments to address. Professor El-Serag emphasizes that Africa’s challenges are compounded by overlapping risks: “Legacy issues like hepatitis persist even as Westernized diets introduce new threats. Without coordinated action, health systems risk being overwhelmed.”

With liver cancer already ranking as the sixth most common cancer and third deadliest worldwide, the report frames the coming decades as a critical window. Public awareness campaigns, early detection programs, and policies promoting healthier diets, experts argue, could shift the narrative from inevitability to opportunity.