Hepatocellular Carcinoma: Role of Hepatitis Viruses and Liver Cell Dysplasia

Hepatocellular carcinoma (HCC) is the most common primary malignancy of the liver. HCC is a major problem worldwide because of its high prevalence and severe natural history and it is the major cause of cancer-related mortality in sub-Saharan Africa and in the Far East (1). HCC is the seventh most prevalent cancer in men and the ninth most common in women, with an estimated total of one million cases occurring each year (2-6). It carries a dismal overall prognosis: 92% of affected individuals will die because of their disease (3). In general, tumor incidence increases with age and occurs most often between the third and fifth decades of life (2). The distribution pattern shows striking and pronounced geographic and racial variations. The biological characteristics of this tumor vary significantly in different geographical areas, from country to country and even from one part of a country to another. Because of the widely divergent rates of HCC worldwide, it is possible to identify high-, intermediate-, and low-incidence areas. In China and south-east and sub-Saharan Africa, as many as 10-30 new cases per 100,000 males in habitants are reported each year, whereas in northern Europe, North America, and Australia, the annual rates of HCC are less than 3 cases a year per 100,000 males.