Abstract
Hepatocellular carcinoma (HCC), the most common form of primary liver cancer, is relatively rare in the West, but one that is increasing in incidence rapidly and becoming a major public health problem. In the Far East and sub-Saharan Africa, the cancer is common and invariably fatal so that overall, HCC is the second most common cause of cancer-related death. The major risk factor is chronic hepatitis B virus (HBV) infection, particularly in the East, but epidemiological studies that identified this association led to immunisation programmes that have, where implemented vigorously, dramatically decreased the impact of the disease. Similarly hepatitis C virus (HCV), common in Western countries, secondary to intravenous substance abuse, is now a curable disease, and this too is leading to a decrease in incidence. However, increasing rates of obesity and diabetes mellitus have resulted in non-alcoholic fatty liver disease (NAFLD), and this is now, and for the foreseeable future, the major cause of HCC in the West. HCC illustrates how key epidemiological studies have led to prevention strategies that have, arguably, had more impact on the disease than have therapeutic approaches.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
Ferlay J, Parkin DM, Curado MP, et al. Cancer incidence in five continents, volumes I to X: IARC CANCERBase No. 10. 2014. [Internet]. Available at: http://ci5.iarc.fr. Accessed 25 Nov 2014.
Beasley RP, Hwang LY, Lin CC, Chien CS. Hepatocellular carcinoma and hepatitis B virus. A prospective study of 22 707 men in Taiwan. Lancet. 1981;2(8256):1129–33.
McMahon BJ. The natural history of chronic hepatitis B virus infection. Hepatology. 2009;49(5 Suppl):S45–55. [PubMed: 19399792]
Ott JJ, Stevens GA, Groeger J, Wiersma ST. Global epidemiology of hepatitis B virus infection: new estimates of age-specific HBsAg seroprevalence and endemicity. Vaccine. 2012;30(12):2212–9. PubMed: 22273662
Chiang CJ, Yang YW, You SL, Lai MS, Chen CJ. Thirty-year outcomes of the national hepatitis B immunization program in Taiwan. JAMA. 2013;310(9):974–6. PubMed: 24002285
Liaw YF, Sung JJ, Chow WC, Farrell G, Lee CZ, Yuen H, Tanwandee T, Tao QM, Shue K, Keene ON, Dixon JS, Gray DF, Sabbat J, Cirrhosis Asian Lamivudine Multicentre Study Group. Lamivudine for patients with chronic hepatitis B and advanced liver disease. N Engl J Med. 2004;351(15):1521–31.
Umemura T, Ichijo T, Yoshizawa K, Tanaka E, Kiyosawa K. Epidemiology of hepatocellular carcinoma in Japan. J Gastroenterol. 2009;44(Suppl 19):102–7.
El-Serag HB, Kanwal F, Richardson P, Kramer J. Risk of hepatocellular carcinoma after sustained virological response in Veterans with hepatitis C virus infection. Hepatology. 2016;64(1):130–7. https://doi.org/10.1002/hep.28535. Epub 2016 Apr 19
Hassan MM, Hwang LY, Hatten CJ, Swaim M, Li D, Abbruzzese JL, Beasley P, Patt YZ. Risk factors for hepatocellular carcinoma: synergism of alcohol with viral hepatitis and diabetes mellitus. Hepatology. 2002;36:1206–13.
Jepsen P, Ott P, Andersen PK, Sorensen HT, Vilstrup H. Risk for hepatocellular carcinoma in patients with alcoholic cirrhosis: a danish nationwide cohort study. Ann Intern Med. 2012;156:841–7.
Donato F, Tagger A, Gelatti U, Parrinello G, Boffetta P, Albertini A, Decarli A, Trevisi P, Ribero ML, Martelli C, Porru S, Nardi G. Alcohol and hepatocellular carcinoma: the effect of lifetime intake and hepatitis virus infections in men and women. Am J Epidemiol. 2002;155:323–31.
La Vecchia C. Alcohol and liver cancer. Eur J Cancer Prev. 2007;16:495–7. 52.
Morgan TR, Mandayam S, Jamal MM. Alcohol and hepatocellular carcinoma. Gastroenterology. 2004;127:S87–96.
Liu Y, Wu F. Global burden of aflatoxin-induced hepatocellular carcinoma: a risk assessment. Environ Health Perspect. 2010;118(6):818–24. PubMed: 20172840
Hsia CC, Kleiner DE Jr, Axiotis CA, Di Bisceglie A, Nomura AM, Stemmermann GN, Tabor E. Mutations of p53 gene in hepatocellular carcinoma: roles of hepatitis B virus and aflatoxin contamination in the diet. J Natl Cancer Inst. 1992;84:1638–41.
Chen JG, Egner PA, Ng D, et al. Reduced aflatoxin exposure presages decline in liver cancer mortality in an endemic region of China. Cancer Prev Res (Phila). 2013;6(10):1038–45.
Calle EE, Rodriguez C, Walker-Thurmond K, Thun MJ. Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Engl J Med. 2003;348:1625–38.
Starley BQ, Calcagno CJ, Harrison SA. Nonalcoholic fatty liver disease and hepatocellular carcinoma: a weighty connection. Hepatology. 2010;51:1820–32. 47.
White DL, Kanwal F, El-Serag HB. Association between nonalcoholic fatty liver disease and risk for hepatocellular cancer, based on systematic review. Clin Gastroenterol Hepatol. 2012;10:1342–59.
Margini C, Dufour JF. The story of HCC in NAFLD: from epidemiology, across pathogenesis, to prevention and treatment. Liver Int. 2016;36:317–24.
Sahasrabuddhe VV, Gunja MZ, Graubard BI, et al. Nonsteroidal anti-inflammatory drug use, chronic liver disease, and hepatocellular carcinoma. J Natl Cancer Inst. 2012;104(23):1808–14.
Singh S, Singh PP, Singh AG, Murad MH, Sanchez W. Statins are associated with a reduced risk of hepatocellular cancer: a systematic review and meta-analysis. Gastroenterology. 2012;144(2):323–32.
Hagberg KW, McGlynn KA, Sahasrabuddhe VV, Jick S. Anti-diabetic medications and risk of primary liver cancer in persons with type II diabetes. Br J Cancer. 2014;111(9):1710–7.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2019 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Johnson, P. (2019). The Epidemiology of Hepatocellular Carcinoma. In: Cross, T., Palmer, D. (eds) Liver Cancers. Springer, Cham. https://doi.org/10.1007/978-3-319-92216-4_1
Download citation
DOI: https://doi.org/10.1007/978-3-319-92216-4_1
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-92215-7
Online ISBN: 978-3-319-92216-4
eBook Packages: MedicineMedicine (R0)