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Abstract
Hepatocellular carcinoma affects more than 500,000 people globally annually, and five year
mortality exceeds 95%. It is the 6th most common cancer of men and the 11th most common
cancer of women. The incidence of hepatocellular carcinoma is increasing in many
countries. The estimated number of new cases annually is over 500,000 and the yearly
incidence comprises between 2.5 and 7% of patients with liver cirrhosis. The incidence
varies between different geographic areas, being higher in developing areas; males are
predominantly affected, with a 3:2 male/female ratio. The heterogeneous geographic
distribution reflects the epidemiologic impact of the main etiologic factors and
environmental risk.
The Epidemiology of HCC exhibits two main patterns, one in North America and Western
Europe and another in Non-Western Countries.
In Non-Western Countries HCC is the most common cancer, generally affecting men more
than women, and with an age of onset between late teens and 30’s. In Africa; a quarter of the
60 million carriers of hepatitis B virus die either of primary hepatocellular carcinoma or
cirrhosis of the liver. Japan has the highest rate of liver cancer in any industrialized country,
and the annual death rate of 32 000
In the West, HCC is generally seen as rare cancer, normally of those with pre-existing liver
disease. It is often detected by ultrasound screening, and so can be discovered by health-care
facilities much earlier than in developing regions such as Sub-Saharan Africa. The
incidence of hepatocellular carcinoma (HCC) has increased significantly over the past two
decades in the USA; approximately half of this increase is attributed to hepatitis C virus
(HCV), while a minimal or no increase has been related to hepatitis B virus (HBV) or
alcoholic liver disease.
Several factors have been identified as being related to the etiology of HCC. In many cases,
these factors, such as chronic viral hepatitis, alcoholism, hemochromatosis, also causes
chronic liver diseases and cirrhosis.