Editorial foreword special issue “Hepatocellular Carcinoma – A Worldwide Translational Approach”

Abstract

abstract 2009 Elsevier Ireland Ltd. All rights reserved. Primary human liver cancer, of which hepatocellularcarcinoma (HCC) is the predominant type, is a major causeof cancer death worldwide, accounting for almost 600,000deaths per year. Because of poor curability, the number ofHCC deaths occurring each year is roughly equivalent tothe number of new cases. The global epidemiology ofHCC is striking, with both geographic and temporal pat-terns of incidence paralleling exposure to viral etiologicfactors. The highest HCC incidence rates occur in sub-Sah-aran Africa and parts of Asia, areas endemic for chronicinfection with hepatitis B virus. However, liver carcinogen-esis is much more complex than simply reflecting the pres-ence or absence of an antecedent viral infection. Givenchronic hepatitis B or C viruses (HBV, HCV) infection, thereare marked geographical differences in risk for HCC whichremain largely unexplained, the other known causes,including aflatoxin exposure, tobacco smoking, alcoholdrinking, and diabetes, explaining only a relatively smallproportion of cases. Moreover, there is significant variationin the pathological and natural history of the disease. Thepathways by which HCC develop are heterogeneous andinfluenced by a variety of environmental and host factors.This special issue of Cancer Letters dedicated to HCC in-cludes contributions that address the critical research is-sues of this disease from etiology and molecularepidemiology, mechanisms and viruses, and molecular car-cinogenesis, to preclinical models and therapeutic ap-proaches and biomarkers. The reviews were preparedfollowing the meeting ‘‘Hepatocellular carcinoma – AWorldwide Translational Approach” which took place atthe International Agency for Research on Cancer, Lyon,France on July 9–10, 2007.Chronic infection with hepatitis B or C viruses havebeen recognized as human liver carcinogens with the pro-portion of HCC attributable to virally induced chronic hep-atitis being close to 85% in most populations. An efficientHBV vaccine is available since the early eighties and hasbeen used since for universal infant vaccination in severalregions of high endemicity, here Plymoth et al. reviewuniversal vaccination programmes and designed field effi-cacy trials. Epidemiological studies on the seroprevalence