Primary Liver Cancer: An avoidable fate for former drug users

Primary Liver Cancer: An avoidable fate for former drug users

With the European Week Against Cancer now over, EURAD reflects on the need to improve Hepatitis C awareness and testing amongst former as well as current drug users.

22nd June 2012

By Fay Watson

With many of our affiiliate organisations providing long-term support to former drug users, health and social issues are never far from the agenda. At a recent event held by ELPA at the European Parliament, the topic was "Primary Liver Disease: an Avoidable Fate".

To the general public, this topic may seem more suited to those working on alcohol issues, however 78% of all primary liver cancer cases actually develop out of a previous infection with either hepatitis B or C. Whilst a lot has been achieved in the field of hepatitis B vaccination, the majority of people already infected with either hepatitis B or C do not know about their disease. Most worryingly, ELPA estimates that up to 90% of people with the infection in some countries are completely unaware that they have acquired it. Left untreated, hepatitis can further develop into liver cancer, which could be completely avoidable if picked up earlier, through effective screening and detection measures.

As expected by ELPA, those with an elevated or high risk of liver disease (could which progress into liver cancer) were mainly people at risk of a hepatitis infection due to having injected drugs, having received blood before 1992 or those exposed to toxins such as alcohol. Apart from people who have injected drugs (no matter how rarely), those who have previously shared drug paraphernalia, such as straws and needles, are also at risk. In spite of the need for targeted screening programmes, it's important also to realise that a signficiant minority of people may also acquire hepatitis and liver disease without belonging to any risk group as such and that is why comprehensive awareness campaigns and accessible screening services need to be available freely to the public at large.

Such a comprehensive approach, with additional targeted programmes for at-risk groups, should not only help improve detection rates and help get people the treatment they need but it is also helpful in breaking down any stigma people may feel if they approach a screening service. For current drug users, such screening services, if coupled with effective brief intervention and referral mechanisms, may also provide an important route into appropriate treatment services.

In the UK at the moment, a consultation is underway on hepatitis screening, which notes that the numbers of people being tested for hepatitis is still very low and that in the UK, injecting drug use is the main cause of hepatitis C. The consultation committee writing the UK paper specifically stressed that they "were concerned about people who have previously injected drugs" as there is "no evidence on how to effectively reach them".

This is where NGO's like ours, can play a role. We can encourage all of our affiliates and partner agencies to raise awareness and provide hepatitis screening (or a referral to an appropriate service) among the people we support, not forgetting those who have already left treatment. Ideally, this should be provided as part of a wider healthcare package, aimed at improving the overall health and wellbeing of the people our affiliates support.

We know that many of our affiliates already automatically provide healthcare screening for former drug users, however we encourage all NGO's in contact with former drug users to do the same, to help them avoid, what could be a completely avoidable fate.

More information:

Has your service any innovative ways of encouraging uptake or provision of screening programmes? If so, we would love to hear about them so that we can share them with our other partners! Feel free to leave a comment below or e-mail the details to eurad@eurad.net

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