Prevention of hepatocellular carcinoma in nonviral-related liver diseases.
Although chronic infection with hepatitis B virus and/or hepatitis C virus are the most important risk factors for hepatocellular carcinoma (HCC) worldwide, other causes of cirrhosis can also lead to HCC. Given the high prevalence of alcoholism and the worldwide obesity epidemic, the relevant importance of nonviral liver disease-related HCC is expected to increase in the future. Some evidence supports mechanistic interactions between host or environmental factors and chronic viral hepatitis in the development of HCC. For example, food- and water-borne carcinogens have contributed to unusually high rates of HCC in parts of China and sub-Saharan Africa. With some of these conditions, appropriate public health measures to reduce the population's exposure to known etiologic agents, or early therapeutic intervention for 'at-risk' individuals before development of cirrhosis (e.g. hereditary hemochromatosis) can prevent HCC. Community-based programs to discourage and deal with excessive alcohol intake, to promote tobacco smoking awareness, to avoid exposure to aflatoxin and other food toxins, and measures to reduce the pandemic of obesity and diabetes are vital for effective interruption of the rising tide of HCC from nonviral liver disease.
Fan
Jian-Gao
JG
Department of Gastroenterology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China. fanjiangao@gmail.com
Farrell
Geoffrey C
GC
D000428:Alcohol Drinking / Q000009:adverse effects / Q000517:prevention & control; D000728:Androgens / Q000009:adverse effects; D006528:Carcinoma, Hepatocellular / Q000209:etiology / Q000517:prevention & control*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000628:therapy; D004032:Diet / Q000009:adverse effects; D004967:Estrogens / Q000009:adverse effects; D005234:Fatty Liver / Q000150:complications / Q000628:therapy; D005506:Food Contamination; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion; D006432:Hemochromatosis / Q000150:complications / Q000628:therapy; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications / Q000209:etiology / Q000517:prevention & control*; D008113:Liver Neoplasms / Q000209:etiology / Q000517:prevention & control*; D009765:Obesity / Q000150:complications / Q000628:therapy; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D000074606:Smoking Prevention; D014873:Water Pollutants / Q000009:adverse effects
D000728:Androgens; D004967:Estrogens; D014873:Water Pollutants