Stronger action needed to address gaps in liver cancer care

Liver cancer remains one of the most serious yet preventable public health threats in the Philippines. It is now the fourth most common cancer in the country, with 12,544 new cases recorded in 2022, and the third leading cause of cancer-related deaths, claiming 11,653 Filipino lives in the same year. These numbers reflect not just a medical challenge, but a systemic failure to prevent, detect, and treat a disease that is often diagnosed too late.

Chronic hepatitis B infection, the leading cause of liver cancer in the Philippines, continues to affect nearly 5% of the population. Other major risk factors include liver cirrhosis, often the result of untreated viral hepatitis, alcohol-associated liver disease, non-alcoholic fatty liver disease linked to obesity and diabetes, metabolic syndrome, and chronic hepatitis C infection. Many of these risk factors are preventable or manageable through timely vaccination, screening, and sustained access to care.

Yet for many Filipino families, a liver cancer diagnosis arrives as a financial and emotional catastrophe. When a loved one becomes seriously ill, households often face lost income, long-term caregiving responsibilities, and crippling out-of-pocket expenses. In the Philippines, household payments account for about 45% of total healthcare spending — one of the highest rates in Southeast Asia. This reality turns illness into poverty and places unbearable strain on families already struggling to make ends meet.

As the country marks Liver Cancer and Viral Hepatitis Awareness and Prevention Month, civil society organizations are calling for stronger and more coordinated government action to reduce preventable deaths from liver cancer. These groups emphasize the urgent need to scale up prevention, improve early detection, and expand access to modern, life-extending treatments.

The Yellow Warriors Society of the Philippines (YWSP), a national organization of hepatitis B patients and advocates, has underscored that current health programs still fall short of capturing the true social and economic impact of liver cancer on Filipino households. UHC Watch, a civil society group monitoring the implementation of the Universal Health Care (UHC) Law, has echoed this concern and urged PhilHealth to expand benefit packages to cover the full continuum of liver cancer care — from screening and diagnosis to treatment and palliative services.

There are positive developments. In his 2025 State of the Nation Address, President Ferdinand Marcos, Jr. reaffirmed the government’s commitment to strengthening UHC, including PhilHealth’s Yaman ng Kalusugan Program (YAKAP), which supports screening for six priority cancers, including liver cancer. He also directed the Department of Health (DoH) to improve access to the Cancer Assistance Fund (CAF) by publishing a complete list of hospitals offering support for outpatient and inpatient services, diagnostics, and medicines for priority cancers.

These initiatives are welcome, but they must be matched with policies that ensure sustainability, equity, and real-world impact. One critical tool in achieving this is Health Technology Assessment (HTA). HTA helps determine which health interventions — including screening tools, diagnostics, and advanced cancer therapies — are clinically effective, cost-effective, and suitable for public funding under the UHC Law. When used well, HTA can reduce out-of-pocket costs and ensure that limited public resources deliver the greatest benefit to patients.

YWSP has issued a timely appeal for the DoH to adopt a broader, societal perspective in HTA decision-making. As YWSP president Hilario Pajac aptly noted, “Policy decisions should reflect the real value of patients returning to productive life and caregivers remaining employed. The full human and social impact of liver cancer must be considered if we want policies that truly save lives.”

This call is supported by global evidence. A 2025 report by the London-based Office of Health Economics highlights that adopting a societal perspective in HTA can foster innovation and better address both clinical and societal needs, an approach particularly relevant to the Asia-Pacific region, where populations are aging and chronic diseases are rising. The report stresses that evaluating health interventions solely through a narrow healthcare lens risks undervaluing treatments that restore productivity, reduce caregiver burden, and prevent long-term economic losses.

Despite these benefits, the report notes that most Asia-Pacific countries still apply societal perspectives only in limited or supplementary analyses, citing barriers such as methodological constraints, capacity gaps, data limitations, and tight HTA timelines. To address these challenges, it recommends stronger policy support, capacity-building through training and international collaboration, better patient and caregiver engagement, and more consistent integration of societal value elements into HTA processes.

Meanwhile, innovation in liver cancer treatment continues to advance. Targeted therapies now disrupt specific pathways that allow cancer cells to grow and spread, while immunotherapies harness the body’s immune system to recognize and destroy cancer cells. These therapies offer hope particularly for patients diagnosed at later stages, but only if they are made accessible through inclusive and evidence-informed health policies.

Closing the gaps in liver cancer care will require a holistic and intersectoral response. Government, civil society, clinicians, and the private sector must work together to strengthen prevention, expand early detection, and ensure equitable access to effective treatments. For Filipino patients and their families, timely action is not just a policy choice. It is a matter of survival, dignity, and hope.