Reducing the global burden of liver cancer: Recommendations from The Lancet commission

Liver cancer is the sixth most common cancer as well as the third highest cause of cancer-related mortality worldwide. In particular, a subtype of liver cancer known as hepatocellular carcinoma accounts for around 80% of all liver cancer cases. Given the increasing disease burden of hepatocellular carcinoma globally, a Commission consisting of experts in a wide range of fields – from clinical medicine to public health – has now been established to tackle this issue.

Recently, in a comprehensive report published online in The Lancet on July 28, 2025, the members of this Commission, chaired by Professor Masatoshi Kudo from Kindai University as well as Professor Jian Zhou and Professor Jia Fan from Fudan University in China, presented their findings, emphasizing the need to tackle the disease burden posed by hepatocellular carcinoma. The content of this report involved a systematic process consisting of idea generation, literature reviews, evidence scoping, novel data synthesis, modeling, as well as case study analyses to provide real-world examples.

First, the authors of this report conducted analyses to project future trends in hepatocellular carcinoma cases by the year 2050. More specifically, they aimed to define some concrete goals for reducing the burden of hepatocellular carcinoma worldwide. One of these goals, as defined in the report, states that an annual reduction of at least 2% is required in the age-standardized incidence rates of liver cancer to tackle its growing disease burden. On a more positive note, there are a number of modifiable risk factors for liver cancer, including hepatitis B and C as well as alcohol use. “Based on a conservative estimate, at least 60% of liver cancer is preventable via control of these risk factors,” notes Prof. Kudo.

Given these projections and goals for the year 2050, the authors presented a set of ten evidence-based recommendations to tackle hepatocellular carcinoma that fall under a few broad themes: disease prevention, early detection, and treatment. Additionally, they This highlighted the need to tackle disparities that exist in terms of access to these three aspects of healthcare. Notably, this is also covered by the ten recommendations.

Viral hepatitis is a well-known risk factor for liver cancer – for starters, the Commission recommended the strengthening of viral hepatitis prevention, screening, and treatment strategies. For further prevention of liver cancer, other recommendations focused on the reduction of alcohol consumption through government measures, controlling environmental risk factors (such as contaminated water), and developing strategies to tackle related diseases such as MASLD (metabolic dysfunction-associated steatotic liver disease) and MASH (metabolic dysfunction-associated steatohepatitis). Moreover, a heavy emphasis was placed on raising awareness about liver health throughout the community.

The Committee also recommended that surveillance strategies should be improved for early liver cancer detection, especially in high-risk populations. In terms of treatment, there should be an effort to improve the survival of patients with hepatocellular carcinoma while addressing differences between the East and West in terms of clinical management. Finally, there is a need for new healthcare models that improve access to treatment even in low- and middle-income countries.

While these recommendations provide a strong framework for tackling hepatocellular carcinoma, the authors caution that there is still a lot of work to be done. “The Commission recognizes that the whole process will be gradual and will require the involvement of multiple stakeholders, including policy makers, healthcare providers, international professional organizations, researchers, and patient advocacy groups,” says Prof. Kudo.

Nonetheless, they are hopeful that the combined efforts will open doors to successful prevention, detection, and treatment of liver cancer across the globe.

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Reference
DOI: 10.1016/S0140-6736(25)01042-6

About Kindai University
Kindai University was established in 1949 after the merger of Osaka Technical College (founded in 1925) and Osaka Science and Engineering University (founded in 1943). Over the past several decades, the university has transformed into a comprehensive educational organization with an ever-growing reputation. Kindai University has over 2,200 full-time faculty members, 6 campuses, and 18 research centers. As an academic institution offering a broad range of programs from across disciplines, Kindai University strives to impart practical education while nurturing intellectual and emotional capabilities. The university’s academic programs are fully accredited by Japan’s Ministry of Education, Culture, Sports, Science and Technology as well as by the National Institution for Academic Degrees and University Evaluation.

Website: https://www.kindai.ac.jp/english/

About Professor Masatoshi Kudo from Kindai University
Masatoshi Kudo is currently Professor and Chairman at the Department of Gastroenterology and Hepatology, Faculty of Medicine at Kindai University in Japan. He received his PhD in Medical Science in 1987 from the Kyoto University Graduate School of Medicine. His research interests lie in the diagnosis and treatment of hepatocellular carcinoma. Prof. Kudo has published over 1379 peer-reviewed papers in well regarded journals, accumulating over 82,700 citations to his credit. He is currently an AASLD Education Committee Member and is serving as an Editor in Chief of LIVER CANCER.

Funding information  
This Commission was supported by grants from the Natural Science Foundation of China (82488101), Non-communicable Chronic Diseases-National Science and Technology Major Project (2024ZD0525400), and Shanghai Municipal Science and Technology Major Project.