Abstract
Most cases of hepatocellular carcinoma (HCC) are associated with cirrhosis related to chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infection. Changes in the time trends of HCC and most variations in its age-, sex-, and race-specific rates among different regions are likely to be related to differences in hepatitis viruses that are most prevalent in a population, the timing of their spread, and the ages of the individuals the viruses infect. Environmental, host genetic, and viral factors can affect the risk of HCC in individuals with HBV or HCV infection. This review summarizes the risk factors for HCC among HBV- or HCV-infected individuals, based on findings from epidemiologic studies and meta-analyses, as well as determinants of patient outcome and the HCC disease burden, globally and in the United States.
Highlights
According to the International Agency for Research on Cancer, liver cancer is the fifth most common cancer in men worldwide (523,000 cases per year, 7.9% of all cancers) and the seventh in women (226,000 cases per year, 6.5% of all cancers)
The 5-year cumulative risk of developing Hepatocellular carcinoma (HCC) for patients with cirrhosis ranges between 5% and 30%, depending on etiology, region or ethnicity, and stage of cirrhosis[1]
Phylogenetic studies of hepatitis C virus (HCV) diversity described the chronology of the spread of HCV epidemics in Japan, Europe, and the US; these findings account for the geographical differences in the timing of the burden of HCV-related HCC 3
Summary
According to the International Agency for Research on Cancer, liver cancer is the fifth most common cancer in men worldwide (523,000 cases per year, 7.9% of all cancers) and the seventh in women (226,000 cases per year, 6.5% of all cancers). Most of the burden of liver cancer is in developing countries, where almost 85% of the cases occur. Hepatocellular carcinoma (HCC) is the most common form of liver cancer; most cases of HCC (approximately 80%) are associated with chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infections. Cases of HCC are increasing in low-incidence areas such as the United States and Canada. In low-risk populations, the highest incidence of HCC is among individuals 75 or older. In Qidong, China, where HCC burden is among the world’s highest, the age-specific incidence rates among men increases until 45 years and plateaus; among women, the incidence rate increases until 60 years and plateaus. HCC is predominant among men, with the highest male:female ratios in areas of high incidence (Figure 1)
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