Commonly Used Blood Test Predicts Cancer Risk

Liver cancer risk can be predicted with transaminase enzymes

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) There are certain risk factors for liver cancer that are well-known, including infection with the hepatitis B and C virus. But for the general population, there really isn’t an effective screen – until now.

A commonly used blood test that measures two enzymes is extremely accurate in determining liver cancer risks in the general population.

The two enzymes found to be the best predictors are alanine transaminase (ALT) and aspartate transaminase (AST) and they are routinely checked by primary physicians and internists.

"If you’re over the age of 50, get tested for hepatitis C."

These are the findings of The University of Texas MD Anderson Cancer Center and a team of scientists in Taiwan.

"These two enzymes alone predicted 91 percent of liver cancer cases in our prospective study," said paper senior author Xifeng Wu, MD, PhD, professor and chair of MD Anderson's Department of Epidemiology. 

"If our research is confirmed in other studies, we'd have a measure for liver cancer risk that's easy to apply via a simple blood test that's already in widespread clinical use," Dr. Wu said in a press release.

Infection with hepatitis B and C viruses increase a person’s odds of developing liver cancer. However, about 35 percent of liver cancer patients don’t have these infections.

The enzyme tests can measure risks for this cancer in anyone.

"Knowing their risk would allow people to respond with lifestyle changes to address other risk factors, such as stopping smoking, reducing alcohol consumption, engaging in physical activity and better managing diabetes," Dr. Wu said.

For this study, researchers analyzed the medical, demographic and lifestyle information 428,584 people in Taiwan from 1994 to 2008. A total of 1,668 cases of liver cancer developed in these who were followed for an average of 8.5 years.

Study participants were divided into two groups, those who had hepatitis C and those with a confirmed diagnosis of hepatitis B.

Dr. Wu and her team analyzed volumes of data on the patients. Study members routinely completed a 100-item questionnaire that looked at everything from personal health characteristics (blood pressure, weight, BMI, etc.) and lifestyle choices (smoking, drinking) to comprehensive medical history (disease diagnosis, medical tests and screens, etc.).

Researchers analyzed all this data, quantified it, stratified it and found that the liver enzyme measures alone detected just over 91 percent of the liver cancers. When hepatitis B and C status was added to the enzyme test results, the accuracy for predicting liver cancer increased to 94 percent.

The authors wrote, “In this study, we developed prediction models for hepatocellular carcinoma based on data routinely collected in a typical office visit with the goal to provide a simple, efficient, and widely available tool to identify and quantify cancer risk in the average-risk population."

Nearly 29,000 Americans will be diagnosed with liver cancer this year, and 20,500 people will die from the disease.

The study was published October 16 in the Journal of the National Cancer Institute.

The study was funded by grants from the MD Anderson Center for Translational and Public Health Genomics of the Duncan Family Institute for Cancer Prevention and Risk Assessment, MD Anderson Cancer Center Trust and the Taiwan Department of Health Clinical Trial and Research Center of Excellence.

No conflicts of interest were supported.

Reviewed by: 
Review Date: 
October 16, 2012
Last Updated:
October 18, 2012