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UH center seeks clues to isles’ high liver cancer rate

Kristen Consillio

University of Hawaii Cancer Center researchers are seeking legislative funding for a three-year study to determine why Hawaii has one of the highest rates of liver cancer in the country.

The Senate Commerce, Consumer Protection and Health Committee on Thursday passed Senate Bill 2049, which would provide $1.1 million for research into whether liver fluke (parasitic worm) infection from eating raw watercress and ingesting a toxin produced by a fungus that grows on aged food contributes to the higher incidence of the disease.

There are about 1,000 liver cancer patients in Hawaii and 184 new cases each year. While other cancers (stomach, lung, colon and prostate) are decreasing locally, liver cancer is rising 1 to 2 percent a year, said professor Wei Jia of the UH Cancer Biology Program. The state’s liver cancer rate is 33 percent higher than the national average, according to UH scientists.

BY THE NUMBERS

1,000

Liver cancer patients in Hawaii

184

Number of new cases each year

$1.1M

Amount Senate Bill 2049 would fund

Major risk factors for the disease include the hepatitis B and C viruses, as well as obesity and heavy alcohol consumption — no different from national averages — “suggesting that there are other unknown factors unique to the population, lifestyles and environment of Hawaii that contribute to the high occurrence of liver cancer,” Jia said.

Scientists will study the two environmental contaminants — liver fluke infection and ingestion of aflatoxin, a toxic carcinogen produced by a fungus prevalent in warm and humid areas that can grow on aged grains such as rice, corn and nuts — and propose strategies for liver cancer prevention.

“If we eat food that’s stored long term — half a year, 1-year-old rice or corn — that could be dangerous because some fungus may grow and produce aflatoxin … one of most potent carcinogens for liver cancer,” Jia said. “What surprised us in Hawaii is nobody’s really studying it.”

‘Very slow and quiet’

The contaminants cause chronic inflammation in the liver leading to the development of the disease over decades with no obvious symptoms, he said.

“In other words, they cause liver cancer, a big problem, in a very slow and quiet way.”

The prognosis for the disease is “pretty bad and devastating,” with the five-year survival rate at only 17 percent, said Herbert Yu, the Cancer Center’s program director.

“Thus, before we can find a cure for the cancer, it is critical for us to find ways to prevent or at least to lower the risk of the disease,” he said. “We know this is possible because liver cancer takes at least 10 to 15 years to develop, and during that time many pre-cancer lesions can be fixed or are reversible if we can remove the risk factors that cause the tissue damage.”

Lucien Wong, who lost his wife to cancer of the bile duct, which is part of the liver, said he has long suspected liver flukes contributed to the disease. Wong testified in favor of the bill.

The Centers for Disease Control and Prevention says people can get infected by the flatworm by accidentally swallowing the parasites, mainly by eating raw watercress or other contaminated freshwater plants.

“There are unique things that occur here in Hawaii. There may be other opportunities to look at local illnesses and sicknesses,” he said. “I was very surprised to learn that if this bill is passed, this would be the first time the state has funded research for local people through the UH Cancer Center.”

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