title: Epidemiology and natural history of hepatocellular carcinoma.
abstract: Hepatocellular carcinoma (HCC) is a major contributor to cancer incidence and mortality. There is a wide variation, however, in the global distribution of HCC. Eighty percent of the burden is borne by countries in Asia and sub-Saharan Africa. In most high-risk countries, principal risk factors include infection with hepatitis B virus and dietary exposure to aflatoxin B(1). In contrast, hepatitis C virus and alcohol consumption are more important risk factors in low-risk countries. In recent years, the incidence of HCC has decreased in some high-risk countries and increased in some low-risk countries. Reasons for both trends are not completely understood, but are likely related to public health efforts in Asia and the increase in hepatitis C virus infection in low-risk countries. Vaccination programs against hepatitis B virus will likely decrease the HCC rate even further in decades to come.
authors.affiliation: HREB/DCEG, National Cancer Institute, EPS-7060, 6120 Executive Boulevard, Rockville, MD 20892, USA. mcglynnk@mail.nih.gov
authors.forename: Katherine A
authors.initials: KA
authors.lastname: McGlynn
authors.forename: W Thomas
authors.initials: WT
authors.lastname: London
mesh_terms: D000348:Aflatoxins / Q000009:adverse effects; D000428:Alcohol Drinking; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology* / Q000235:genetics / Q000628:therapy / Q000821:virology; D018890:Chemoprevention; D005506:Food Contamination; D020022:Genetic Predisposition to Disease; D014943:Global Health; D006509:Hepatitis B / Q000150:complications; D006526:Hepatitis C / Q000150:complications; D006801:Humans; D015994:Incidence; D008103:Liver Cirrhosis / Q000150:complications; D008113:Liver Neoplasms / Q000453:epidemiology* / Q000235:genetics / Q000628:therapy / Q000821:virology; D012307:Risk Factors
chemical_list: D000348:Aflatoxins