Liver Cancer

Primary liver cancer is the sixth most frequently occurring cancer in the world and the second most common in terms of cancer deaths. The global burden of liver cancer is borne principally by countries in East Asia and Africa, where 80% of liver cancer arises. Incidence rates of liver cancer, however, have begun to decline in Asia, while rates are increasing in low-rate areas such as Europe and North America. The dominant histology of liver cancer in almost all countries is hepatocellular carcinoma (HCC). The major risk factors for HCC—chronic infection with either hepatitis B virus (HBV) or hepatitis C virus (HCV), aflatoxin B1 (AFB1) contamination of foodstuffs, excessive alcohol consumption, and diabetes/obesity/fatty liver disease—all result in chronic inflammation in the liver. HBV infection is preventable by immunization, and HCV infection is largely preventable by public health measures and now is curable with new antiviral therapies.