Liver (Hepatocellular) Cancer Prevention (PDQ®): Prevention - Health Professional Information [NCI] - Significance
Incidence and Mortality
Hepatocellular cancer (HCC) is the fourth most common cancer in the world and the third leading cause of cancer mortality worldwide. Age-standardized incidence rates are 2.1 per 100,000 population in North America. In the United States, HCC incidence and mortality rates continue to increase, particularly among middle-aged black, Hispanic, and white men.
It is estimated that there will be 30,640 new cases diagnosed and 21,670 deaths due to this disease in the United States in 2013. There is a distinct male preponderance among all ethnic groups in the United States, although this trend is most marked among Chinese Americans, in whom the annualized rate of HCC is 22.1 per 100,000 population among men and 8.4 per 100,000 population among women.Table 1 summarizes the incidence of HCC by geographic region.
In the United States, chronic hepatitis B is the underlying cause of an estimated 2,000 to 4,000 deaths each year from cirrhosis and liver cancer; it is estimated that more than one million Americans have a chronic hepatitis B infection, many of whom do not know they are infected. Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are among the most frequent viral infections in humans and represent a major global public health problem. HBV- and HCV-related chronic hepatitis are the main causes of cirrhosis and HCC, which are responsible for a high rate of morbidity and mortality. In the last few years, knowledge of the epidemiology and the natural history of HBV and HCV infections has markedly improved, and considerable progress has been made in the efficacy of therapy.
Table 1. Incidence of Hepatocellular Carcinoma by Geographic Regiona
|Region||Incidence (per 100,000 population)|
|a Adapted from Russo et al.|
HCC is very rare in persons younger than 40 years in the United States, and a much higher risk of HCC is associated with a long duration of infection with hepatitis C (e.g., greater risk after 30 years of infection). About 80% of persons with HCC have cirrhosis.
Viruses Associated With Hepatitis and/or Hepatocellular Cancer
There are several types of viruses associated with hepatitis and/or HCC. Hepatitis is also the name of a family of viral infections that affect the liver; the most common types are hepatitis A, hepatitis B, and hepatitis C.
Table 2. Viruses Associated With Hepatitis
|Hepatic Virus Types||Mode of Transmission||Clinical Consequences|
| || || |
|Hepatitis A||Food, drinking water. Little or no association with cancer.||Full recovery (usually)|
|Hepatitis B||Body fluids, e.g., blood, semen||Can cause liver damage; can result in acute or chronic HCC|
|Hepatitis C||Body fluids, e.g., blood, semen||Acute hepatitis and chronic liver disease, including cirrhosis and liver cancer|
|Hepatitis D||Body fluids, e.g., blood, semen||Acute hepatitis|
|Hepatitis E||Infected drinking water|| |
|Hepatitis F||No virus confirmed|| |
|Hepatitis G||To be determined|| |