Epidemiology, Risk Factors, and Natural History of Hepatocellular Carcinoma

• DOI: 10.1111/j.1749-6632.2002.tb04090.x
• Publication Date: 2010-07-20T21:34:14Z
• Authors: GIUSEPPE MONTALTO; MELCHIORRE CERVELLO; LYDIA GIANNITRAPANI; FABIO DANTONA; ANGELA TERRANOVA; LUIGI A. M. CASTA...
• Keywords: Viral Hepatitis Vaccines; Hepatitis B virus; 0303 health sciences; Aflatoxin B1; Carcinoma, Hepatocellular; Liver Neoplasms; Hepacivirus; Hepatitis B; Hepatitis C; 3. Good health; 03 medical and health sciences; Risk Factors; Alcohols; Humans

A bstract : The incidence of hepatocellular carcinoma is increasing in many countries. estimated number new cases annually over 500,000, and the yearly comprises between 2.5 7% patients with liver cirrhosis. varies different geographic areas, being higher developing areas; males are predominantly affected, a 2:3 male/female ratio. heterogeneous distribution reflects epidemiologic impact main etiologic factors environmental risk, which hepatitis B (HBV) C (HCV) viruses. percentage attributable to HBV worldwide 52.3% Asia where seroprevalence HBsAg population high. However, vaccination campaign against this virus some eastern countries has tended lower carcinoma. HCV 25%, it more prevalent Japan, Spain, Italy association antibodies ranges 50 70%. In most develops cirrhotic livers, persistent proliferation cells represents key factor progression independent etiology. Another minor risk aflatoxin B1 consumption, responsible for Africa, consumption contaminated foods common. Other known hereditary diseases, such as hemochromatosis, porphyria cutanea tarda, tyrosinemia, α 1 anti‐trypsin deficiency. natural history influenced by nodule dimension, mono‐ or plurifocality lesions at diagnosis, growth rate tumor, stage underlying Available data date suggest that tumor variable time lesion undetectable until becomes 2 cm 4 12 months. Therefore, suggested interval surveillance screening ultrasound cirrhosis been set 6 Patients who should benefit from programs those would be treated curative therapy if diagnosed Thus, ideal target limited Child‐Pugh's class without significant comorbidity.