As we await the release of the National Cancer Plan, Liver Cancer Awareness Month is a stark reminder of the urgent need to act on one of the UK’s fastest rising and less survivable cancers.
While the UK has made impressive progress in reducing deaths from several cancers, liver cancer stands apart. Each year, over 6,300 people die from liver cancer in the UK, and alarmingly, 49% of these deaths are preventable.
It has the fastest-growing mortality rate of any major cancer, with deaths increasing by 50% in the last decade. New data shows that deaths from liver cancer in England and Wales increased by 41% between 2013 and 2024 with the disease now accounting for a greater share of overall deaths than in previous years.
This rise is driven by obesity, alcohol harm, viral hepatitis, metabolic syndrome, and deepening health inequalities. But behind these causes lies a more fundamental failing; our system misses opportunities to detect patients early and fails to monitor those most at risk – often disproportionately affecting those in our most deprived communities.
The National Cancer Plan offers an opportunity to reset and address the less survivable cancers and improve liver cancer services and care for all patients.
17 people die every day from liver cancer, while 17 more are newly diagnosed. This grim reality means the five-year survival rate for liver cancer is just 13% – among the lowest of any cancer in the UK. By contrast, comparable countries report markedly higher five-year survival rates: 23% in Australia, 22% in Canada and 43% in Japan.
Alarmingly, these figures are only set to worsen. Recent analysis from One Cancer Voice estimate there will be almost 120,000 new liver cancer cases by 2040. Liver cancer cases are set to double by 2050, with researchers of a Lancet Commission on Liver Cancer highlighting the growing impact of obesity – an estimated 11% of liver cancer cases could be linked to obesity by 2050, up from 5% today.
A key factor behind the stark survival rates is late diagnosis. Liver cancer is a silent killer – the symptoms are non-specific in the early stages (stages I and II) and are often attributed to other causes – resulting in only 19% of liver cancer cases in England being diagnosed early. Almost twice as many cases of liver cancer are diagnosed during an emergency in A&E (42%) as are diagnosed by a GP referral (24%), often when the disease has progressed beyond the point where effective medical intervention is possible. In contrast, 60% of primary liver cancer cases are detected at an early stage in Japan.
Yet, the majority of those diagnosed with liver cancer have known risk factors – pre-existing liver disease, overweight and obesity, metabolic syndrome, alcohol use and viral hepatitis. The opportunities for early detection are missed by a system that does not proactively find those at risk or keep them under surveillance. Notably, cirrhosis, advanced scarring of the liver, is present in as many as 90% of cases of HCC, yet the lack of a national cirrhosis registry means patients can be lost to care. These missed opportunities cost lives.
These missed opportunities do not fall evenly: lives are disproportionately lost in our most deprived communities. In all four nations of the UK, people in the most deprived communities have significantly higher rates of liver cancer than those in the least deprived. In England, men living in the most deprived areas face twice the rate of liver cancer compared with men in the least deprived areas. Surveillance and outreach into these communities is vital to reverse this unacceptable health gap.
As a less survivable and rare cancer, liver cancer may benefit from the Rare Cancers Bill. The bill, introduced by Dr Scott Arthur MP, is making progress with government backing. The bill seeks to incentivise research and investment into the treatment of rare cancers. Similar pieces of legislation in the US, spurred pharmaceutical companies to dramatically increase their research into rare diseases. Prior to the passage of the Orphan Drug Act, only 38 drugs were approved by the FDA for rare disease; by 2022, that number is 882.
Already, promising steps are being taken to improve liver surveillance. NHS England has doubled its deployment of mobile liver scanning teams throughout England, using non-invasive liver scans to offer over 100,000 on-the-spot scans for liver disease. Of those, almost 8,500 have been referred for further checks. Bringing diagnosis out of hospital and into those communities that need it most is a crucial step in reducing the health gaps. New minimum standards for liver cancer surveillance were also published by NHS England in 2024. These are steps in the right direction – proof that surveillance is possible and effective when prioritised.
Yet, the reality on the ground remains inconsistent. A British Liver Trust survey revealed a postcode lottery for liver disease surveillance. Only 20% of health bodies in England have full pathways for early liver disease detection, and most health bodies are still failing to proactively case-find those most at risk. Community Diagnostic Centres were designed to shift care closer to people’s homes and drive prevention, yet only 14 of 160 Community Diagnostic Centres had liver scanning capability as of February 2025.
This Liver Cancer Awareness Month, the British Liver Trust is calling for:
- Immediate action to improve early detection and surveillance of liver cancer.
- A National Cirrhosis Registry to track and monitor high-risk patients.
- Wider access to liver scans (transient elastography and ultrasound) and fibrosis testing in primary care and community settings, including Community Diagnostic Centres.
- Comprehensive early detection pathways for liver disease, to stop preventable cases before they start.
The National Cancer Plan is a generational opportunity to reverse years of neglect and deliver lasting change. It is an opportunity to address less survivable cancers – including liver cancer.
If the government is serious about saving lives, it must confront the reality of liver cancer with the ambition, urgency, and equity the crisis demands.
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