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Gay Men's Health News: Liver Cancer On the Rise from Untreated Hepatitis

By L.K. Regan

A new study released yesterday is getting a lot of attention for showing that liver cancer rates are on the rise in the US. Gay men need to be particularly attentive to this news, because the rise in liver cancer cases is directly associated with the prevalence of untreated hepatitis, a virus unfortunately common in the gay community.

The U.S. Centers for Disease Control and Prevention (CDC) released a Morbidity and Mortality Weekly Report Thursday detailing a substantial rise in hepatocellular carcinoma, a form of liver cancer. Since 78 percent of cases of this cancer are caused by chronic hepatitis B and C, the CDC is putting a spotlight on the 5.3 million Americans who have chronic viral hepatitis and don’t know it. As cases of untreated hepatitis rise, so do liver cancer cases—according to the report, from 2.7 per 100,000 persons in 2001 to 3.2 in 2006, an average annual increase of 3.5 percent.

You have to be sick with hepatitis for a long time for liver cancer to result. But, according to the CDC report, many of the cases are in older people who were infected before commonplace testing or effective treatments. This should be preventable. According to Dr. John Ward, director of CDC's viral hepatitis division and co-author of the report, good treatments exist for hepatitis. "These will be even more effective in the future when new drugs currently in development come on the market," he said. “In the long term, like 20 or 30 years and beyond, our prospects are very bright as far as preventing liver cancer from viral hepatitis.” But, he continued, “we still have about 50,000 persons who become infected with hepatitis every year and we would like to get that rate lower still.”

Here’s a start on getting that rate lower. There are three types of hepatitis, A, B and C. All are important for gay men to know about: among adults, gay men account for 10 percent of new hepatitis A diagnoses, and 20 percent of new hepatitis B cases. Hepatitis A is a passing infection, lasting about six months. But both hepatitis B and C can develop into chronic, even lifelong conditions.

All three forms can be sexually transmitted, B especially so; B is substantially more infectious than HIV, though like HIV, it can be prevented through correct condom use. Hepatitis C is carried in blood, so its transmission is often the result of intravenous drug use, though scientists believe it can be transmitted sexually as well. It is particularly prevalent among people with multiple sex partners, with an STD, and/or with HIV/AIDS. Like hepatitis B (and HIV), religious condom use is key to prevention. All of which means that hepatitis is a gay man’s health concern—but while many of us are conscientious about HIV testing, we are far less likely to be tested for hepatitis B even though it is up to 100 times more transmissable.

What should you do? If you’ve never been tested for hepatitis B, now is the time. There is a very successful vaccine for hepatitis B, the study’s authors point out, so anyone who tests negative is in a very good position as long as they get vaccinated. "There is a vaccine against hepatitis B that is routinely given to infants—so our children are protected, but adults, for the most part, are not," said Dr. Ward. Wanting to leave nothing to chance, the CDC advises scheduling your vaccination and your test for the same day. Get tested and get the shot in one fell swoop.

Hepatitis C is less well-known, having been identified only a couple of decades ago, in 1990. There is not yet a vaccine for hep-C, but there are treatment options. And as the CDC’s new report indicates, turning a blind eye is no kind of solution. Use condoms, get tested, seek treatment. May is Hepatitis Awareness Month. Why not now?