Accelerating action: scaling up liver cancer prevention through hepatitis elimination in Europe
Hepatitis elimination is cancer prevention. However, the link between the two diseases is not well understood. Liver cancer is the sixth leading cause of cancer-related deaths in Europe, with most cases caused by viral hepatitis. While the tools to eliminate viral hepatitis exist, less than 40% of people living with hepatitis have been diagnosed in the EU/EEA. This gap is even greater within the wider World Health Organization (WHO) region, where only 30% have been diagnosed with less than 10% on treatment.
It is imperative that we act now to turn the tide and prevent liver cancer by driving action on hepatitis elimination in Europe. The framework for this action already exists through Europe’s Beating Cancer Plan, which calls for the prevention of liver cancer through vaccination against hepatitis B and treatment of hepatitis C. The European Union also committed to further scaling up liver cancer prevention through increased hepatitis testing, treatment and vaccination by adopting the new UN political declaration on noncommunicable diseases (NCDs).
To help drive progress in Europe, the World Hepatitis Alliance has developed a policy toolkit for all stakeholders looking to strengthen liver cancer and hepatitis responses. It summarises the current policy landscape, highlights gaps driving inequities within both responses, and offers practical, actionable next steps to accelerate progress towards scaling up liver cancer prevention through hepatitis elimination.
WHA in partnership with the European Cancer Organisation (ECO), the European Association for the Study of the Liver (EASL), and the European Liver Patients’ Association (ELPA), also organised an event to bring together different stakeholders to discuss how to finance and embed comprehensive hepatitis programmes into national cancer plans, as part of the new EU budget.
Hosted by MEP Vytenis Andriukaitis, speakers included:
- MEP Romana Jerkovic, Croatia
- MEP Nikos Papandreou, Greece
- Professor Dr Christoph Boesecke, Senior Physician, University of Bonn, Germany
- Professor Maria Buti, Professor of Medicine and Consultant of Hepatology, University Hospital Vall d’Hebron, Spain
- Patrizia Carrieri, Policy and Public Health Committee Member, EASL and Co-chair, ECO HPV and Hep B Action Network
- Ivana Dragojevic, Vice-President and Treasurer, European Liver Patients’ Association (ELPA)
- Rachel Halford, Past President, World Hepatitis Alliance
- Jessica Hicks, Senior Director, World Hepatitis Alliance
- Matthias Pinter, Department of Medicine III, Medical University of Vienna, Austria
- Richard Price, Policy Director, European Cancer Organisation (ECO)
- Stuart Smith, Director of Community Services, Hepatitis C Trust
The event aimed to reinvigorate the hepatitis C response in Europe by exploring solutions to slowed progress in scaling up and implementing national responses.
Speakers pictured (from left to right): MEP Romana Jerkovic, MEP Nikos Papandreou, MEP Vytenis Andriukaitis and Rachel Halford
Key takeaways from the discussion included:
- The tools to prevent hepatitis and liver cancer exist, but a lack of political will, robust data, and sustainable funding has created an implementation gap for these cost-effective interventions.
- Significant inequities in hepatitis and liver cancer responses exist between EU Member States, leading to variable access to care and unequal health outcomes across the European Union.
- Stigma and discrimination faced by people living with hepatitis continue to be significant barriers to elimination and liver cancer prevention, contributing to late diagnosis rates and loss to follow up.
- Increasing screening in accessible settings is essential to improve diagnosis rates across Europe. In Spain, offering free hepatitis C testing in hospitals has significantly reduced liver cancer caused by hepatitis C by increasing early diagnosis, strengthening linkage to care, and reaching populations less likely to access GP services such as migrants.
- Expanding integrated testing services is key to improving early diagnosis and reducing liver cancer cases. In Germany, offering hepatitis testing alongside other routine GP screening has increased newly diagnosed hepatitis B cases by 160% and hepatitis C cases by 120% in 2023.
- Civil society is uniquely placed to address barriers to hepatitis elimination and liver cancer prevention such as stigma, by raising awareness, increasing knowledge, and supporting linkage to care.
- Scaling up hepatitis elimination and liver cancer prevention in Europe will require sustained commitment, financing, and collaboration between all stakeholders, including policymakers, health care professionals, civil society and people with lived experience.
Supported by AbbVie