How a state-wide initiative is changing the fight against one of America's fastest-rising cancers
In the vast landscape of Texas, a quiet health crisis has been unfolding. Liver cancer, specifically hepatocellular carcinoma (HCC), has become the fastest-rising cause of cancer-related deaths in the United States, with Texas bearing the unfortunate distinction of having the highest age-adjusted incidence rate in the nation2 6 .
Five-year survival rate for HCC
Texas has highest HCC incidence rate in U.S.
Goal to reduce liver cancer mortality
The numbers tell a sobering story: the five-year survival rate for HCC remains dismal at less than 15%, with cure only possible for a small proportion of patients detected at an early stage2 . Faced with this growing threat, the Lone Star State has launched an innovative response—the Texas Collaborative Center for Hepatocellular Cancer (TeCH).
This unprecedented initiative brings together researchers, clinicians, healthcare systems, and communities in a unified front to tackle liver cancer from all angles. TeCH represents a paradigm shift in how we approach complex health challenges—through coordination, collaboration, and advocacy with the ambitious goal of reducing liver cancer mortality in Texas by 20302 6 .
Understanding why Texas has been hit particularly hard by HCC requires examining the unique combination of risk factors prevalent across the state. A convergence of rising metabolic dysfunction-associated fatty liver disease (MAFLD), high rates of hepatitis C infection, and significant alcoholic liver disease has created what researchers describe as a "perfect storm" for liver cancer development2 6 .
Affects approximately 25% of global adult population; rising prevalence in Texas7
High prevalence contributing to increased HCC risk2
Significant factor in Texas' high HCC rates2
Less common than HCV but remains an important risk factor1
From various causes (viral hepatitis, alcohol, metabolic factors)
Scar tissue begins to form in the liver
Advanced scarring that impairs liver function
Malignant transformation occurs in the diseased liver environment7
Recognizing that focusing solely on treatment would be insufficient, TeCH has developed and published a conceptual model designed to improve both primary and secondary prevention of HCC2 6 .
Implementing a statewide program to address one of the most significant drivers of HCC9
Increasing awareness about nonalcoholic steatohepatitis and obesity, major risk factors for MAFLD9
Combining treatment for alcohol-associated liver disease with treatment for alcohol use disorder9
Target Population: Individuals at risk for liver disease
Target Population: Patients with established liver disease
Target Population: Patients with early-stage HCC or history of HCC
While prevention remains crucial, early detection represents one of the most promising avenues for improving HCC outcomes. One groundbreaking approach emerging from liver cancer research involves a novel technology known as the EV Click Chip, which purifies HCC-specific extracellular vesicles for early detection5 .
Uses "click chemistry"—a highly specific reaction between tetrazine (Tz) and trans-cyclooctene (TCO) molecules—to irreversibly bind HCC-specific EVs to the chip surface5
Employs a combination of antibodies targeting three HCC-associated surface markers (EpCAM, ASGPR1, and CD147) to recognize the diverse subtypes of HCC EVs5
Incorporates densely packed silicon nanowires that dramatically increase the surface area available for capturing EVs5
Uses specially designed microfluidic channels that create chaotic mixing, enhancing physical contact between EVs and the capture surface5
Excellent diagnostic accuracy (1.0 represents perfect test)
High ability to correctly identify true positive HCC cases
High ability to correctly identify true negative cases (cirrhosis without HCC)
As TeCH continues its work, several promising developments signal new directions in the fight against liver cancer. Recently, UT Southwestern Medical Center was named a Specialized Program of Research Excellence (SPORE) for liver cancer, accompanied by a $12 million grant from the National Cancer Institute8 .
These initiatives, combined with TeCH's collaborative model, represent a comprehensive approach to tackling HCC—from preventing its development in at-risk individuals to improving outcomes for those already diagnosed.
The Texas Collaborative Center for Hepatocellular Cancer represents more than just a research initiative—it embodies a new approach to addressing complex health challenges. By breaking down traditional silos between institutions, disciplines, and sectors, TeCH has created a framework for meaningful progress against one of the most pressing cancer threats facing Texas and the nation.
While the goal of reducing liver cancer mortality by 2030 is ambitious, the coordinated efforts in prevention, early detection, and treatment optimization through initiatives like TeCH and the UTSW SPORE program provide genuine hope. As this collaborative model demonstrates, effectively addressing complex health challenges requires more than scientific advances—it demands coordination, collaboration, and advocacy across the entire ecosystem of healthcare.
The battle against hepatocellular carcinoma in Texas is far from over, but through initiatives like TeCH, the state is building a comprehensive defense—one that may eventually serve as a model for cancer control efforts nationwide.