1. Epidemiology and natural history of hepatocellular carcinoma.
- Author
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McGlynn, Katherine A. and London, W.Thomas
- Subjects
LIVER cancer ,DISEASE risk factors ,HEPATITIS C virus ,PHYSIOLOGICAL effects of alcohol ,VACCINATION - 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. [Copyright &y& Elsevier]- Published
- 2005
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