Promising New Liver Cancer Screening Program for Native Alaskans Could Be Effective in Developing Countries

CHICAGO, November 10 - At the American Association for the Study of Liver Diseases 1998 Annual Meeting inChicago, November 6 - 10, researchers discussed disturbing new findings indicating that interferon, the most commonly used drug against chronic Hepatitis C, is much less effective for African Americans than it is for other racial and ethnic groups.

Jay Hoofnagle, MD, of the National Institutes of Health, discussed a study of the role race and ethnicity play in determining how well patients respond to using interferon to treat chronic Hepatitis C. A large, randomized, North American controlled trial of response to interferon compared African American, Caucasian, Hispanic, and Asian patients who were similar in age and in their levels of Hepatitis C virus (HCV) as measured by an antibody called HCV RNA.

At the end of the interferon therapy, only 5% of African-Americans became HCV RNA negative, as opposed to 33% of Causasians, 28% of Hispanics, and 40% of Asians. "The differences in response to interferon in HCV is as yet unexplained," according to the abstract of the research findings presented at the AASLD meeting, "but have major implications for future directions in the therapy of the disease.

For another ethnic minority, Native Alaskans, the AASLD Annual Meeting had some positive news. Brian J.McMahon, MD, of the Alaska Native Medical Center in Anchorage, AK, reported on a screening program that is helping to detect liver cancer and improve survival rates. In late 1982, the Alaska Native Medical Center launched a state-wide program to conduct regular blood tests of all Alaska Natives who have chronic Hepatitis B. Persons with chronic Hepatitis B are at a high risk of developing liver cancer during their lifetimes. The tests evaluated the level of alpha-fetoprotein (AFP) in blood, which is an indicator of liver cancer. Those with elevated AFP were checked for tumors with ultrasound and treated when necessary. The five and ten year survival rate for those found to have Hepatitis C, were 45% and 24% respectively compared to 0% for patients diagnosed with liver cancer prior to the screening program. The program is effective in part because the AFP tests are easy to perform, and the program is relatively cheap to administer and coordinate, a requirement for dealing with the Alaska Native population, which lives in widely dispersed, isolated locations. "In Third World countries and perhaps China, where large numbers of people have been infected with Hepatitis B very early in life, this kind of program could be very effective," says McMahon.

AASLD is the leading medical organization for liver researchers and physicians. Founded by physicians in 1950, AASLD's mission is to advance the science and practice of hepatology. Today, AASLD provides representation and education for more than 2,200 hepatologists worldwide.