KUALA LUMPUR, Dec 18 — Obesity, which is seen commonly in Malaysia as one of the causes of non-alcoholic fatty liver disease, could lead to liver cancer, a consultant hepatologist said.
Consultant hepatologist Dr Rosmawati Mohamed, a professor from University Malaya, highlighted that liver cancer is the cause of premature deaths in Malaysia and according to the trend, death cases have increased by 31.5 per cent since 1990 to 2020.
Dr Rosmawati, in a virtual workshop last month, said that fatty liver or non-alcoholic fatty liver disease is now a major health problem and has emerged as the commonest liver disease, worldwide, including Malaysia.
Non-alcoholic fatty liver disease is mainly related to globebsity (global obesity), which is also seen in Malaysia. Obesity is defined as a body mass index (BMI) of more than 30kg/m2. Non-alcoholic fatty liver disease is caused by the build-up of fat in the liver.
“The recent data from the National Health and Morbidity Survey 2019 that was published a few months ago, showed that one in two adults in Malaysia are either overweight or obese and one in two have abdominal obesity,” Dr Rosmawati said.
According to Dr Rosmawati, 90 per cent of liver cancer occurs in patients who have liver cirrhosis (scarring of the liver tissue), with most commonly results from chronic liver disease like Hepatitis B, Hepatitis C, non-alcoholic liver disease, excessive alcohol consumption etc.
During the virtual workshop, Dr Rosmawati also pointed out that fatalities from liver cancer have been increasing worldwide and is the fourth most common cancer in causing deaths globally.
She said that although liver cancer doesn’t feature in the top 10 causes of cancer globally, it is the fourth most common cancer worldwide in causing deaths, with 700,000 deaths every year.
“From the comparison made from 1990 and you can see the 2017 data shows that the new cases of liver cancer has increased by 100 per cent from 1990 and 2017,” Dr Rosmawati said, referring to global statistics.
From recent data published in October by the World Health Organization’s (WHO) internal agency for research in cancer, it was found that in Malaysia, liver cancer is the sixth most common cancer and also ranked the fourth most common cancer deaths.
“So, here, it is clearly shown that liver cancer is extremely deadly. Most with liver cancer will end up dying within a very short period of time and this is actually true for most cases presenting at a very late stage,” Dr Rosmawati said.
Furthermore, Dr Rosmawati highlighted that liver cancer symptoms are uncommon hence, one should not be waiting for liver cancer symptoms to develop before presenting themselves to the doctor.
From the year 1989 onwards, the government has made it mandatory for all babies to be vaccinated with Hepatitis B. Hence, Dr Rosmawati urged those who were born before 1989 to check for Hepatitis B at least once, since they are at higher risk of contracting Hepatitis B that could lead to liver cancer.
“Those born before 1989 are at high risk of development of Hepatitis B. So, everyone born before 1989 should get a one-time test for Hepatitis B, particularly if they have a family history of Hepatitis B,” Dr Rosmawati stressed.
Secondly, she also mentioned that testing for Hepatitis C, which spreads through blood, was only made available after 1990. So, all those who were given either blood transfusion, or even platelet transfusion for dengue before 1990 would also have the risk of Hepatitis C.