The liver is the body’s chemical processing plant; a powerhouse crucial to removing toxins as well as distributing and storing essential nutrients. It is one of the most resilient organs, as its cells are the only ones in the body that can regenerate and repair the liver after damage.
However, the incredible capabilities of this unique organ have led to a masking of one of Australia's more insidious, evolving health care problems. Liver diseases now affect up to 1 in 3 Australian adults and conservatively cost Australia $51 billion each year (reference 1).
Identifying liver disease early is crucial to reducing the burden of disease caused by hepatocellular carcinoma in Australia, also known as liver cancer or HCC.
In 2020, a report commissioned by the Australian peak body the Liver Foundation, found liver cancer to be Australia's fastest growing cause of cancer-related deaths (reference 2). Some 85-90% of liver cancer occurs in individuals with cirrhosis of the liver (reference 3), which can result from a poor diet, excessive alcohol consumption, or infection by hepatitis.
Speaking to this urgency, one of Australia's thought leaders on liver cancer, Associate Professor Simone Strasser, recently published an independent commentary in the Australian Medical Research and Journal "Research Review".
The title page of the issue of Research Review, including independent commentary by A/Prof Strasser.
The publication Research Review is circulated to over 6,000 liver cancer and hepatitis HCPs based primarily in Australia. In her experience as Director of the Liver Foundation, A/Prof. Strasser gives extensively referenced details as to the impact of liver disease in Australia and globally.
Entitled "Hepatocellular Carcinoma: The Fastest Rising Cause of Cancer Death," (Reference 4) the detailed 6-page review paper was published as part of an educational series on hepatocellular carcinoma surveillance and the emerging role of biomarker-based models.
In the review paper, A/Prof. Strasser covers at length topics such as non-alcoholic liver disease as an increasing risk factor, hepatocellular carcinoma surveillance including ultrasound as the current standard of care, the nature of patients who should undergo surveillance, serological biomarkers, and biopsy.
Pertinent to the geographic challenges facing Australia's healthcare system, A/Prof Strasser identifies the reality that many of the Australians who are most at risk of HCC live in rural and remote settings. These patients have limited access to ultrasound, the current standard of care, and so risk falling out of ultrasound-based surveillance programs.
Roche biomarkers can play a critical role in improving diagnosis and disease management.
Toward the end of the review paper, further commentary is offered on Australia's current HCC surveillance ecosystem.
As one of Australia's preeminent thought leaders on HCC, A/Prof Strasser explains how ultrasound will always be a useful tool in HCC diagnosis. Yet its limitations, which can be compromised by obesity, fibrotic changes, and even the quality of the device or user experience across regional areas of Australia, necessitate a biomarker assisted surveillance program for HCC to improve the standard of care.
As such, a number of serum biomarker-based models, including GAAD and GALAD algorithms, were evaluated in the review paper. A/Prof. Strasser includes detailed references to retrospective case-control studies and cites comparisons of biomarkers to ultrasound.
As a pioneer of in vitro diagnostic biomarkers for over 30 years, Roche has been investing in well-tested solutions that improve HCC diagnosis in clinical and primary care settings. Among a comprehensive portfolio of cardiac, fertility, and oncology biomarkers, the Roche HCC-specific biomarkers can be combined with ultrasound as a clinical diagnostic tool to diagnose early-stage HCC.
This educational piece in Research Review was commissioned by Roche Australia Pty Ltd. The content is entirely independent and based on published studies and the authors’ opinions.
Reference 1 - https://liver.org.au/ (accessible as of 28 March 2023)
Reference 2 - https://www.liver.org.au/deloittere (accessible as of 28 March 2023)
Reference 3 - https://www.mja.com.au/journal/2021/214/10/australian-recommendations-management-hepatocellular-carcinoma-consensus (accessible as of 28 March 2023)
Reference 4 - https://www.researchreview.com.au/au/Clinical-Area/Internal-Medicine/Medical-Oncology/Liver-Cancer/Educational-Series-–-Hepatocellular-carcinoma-surv.aspx?hash=70e5552165831516d6465aec27f9f8f3d0249420643d6b7ff3a3d85fe4ff2347 (accessible as of 28 March 2023)