HCC Part 1: Epidemiology & Risk Factors

 HCC Part 1: Epidemiology & Risk Factors

- An epithelial tumor originating in the liver and composed of cells with similar characteristics as normal hepatocytes

- Most frequent malignant liver tumor

- 5 th most common cancer

- 3rd  most common cause of death due to cancer

- M>F

- More in developing countries

- Multistage disease linked to environmental, dietary & life style factors 

Etiology:

1. Previously damaged organ (cirrhosis) - Viral B & C / Alcohol / NAFLD

Annual incidence of HCC in cirrhosis is 2 to 8 %.The incidence of higher in following situations

Highest incidence is seen in following situations

a. Hepatitis C or B virus

b. Severity of cirrhosis (decompensated)

c. Geographic (Japan > US/Europe)

d. M>F

e. Multiple risk factors: Alcohol + NAFLD or Hepatitis B/C

2. 15-20 % occur in non-fibrotic liver or liver with minimal portal fibrosis (without any septal fibrosis)

a. Chronic liver inflammation without cirrhosis (Hepatitis B/C - NASH etc)

b. Hereditary disorders - Hemochromatosis / Wilson's disease / a-1-antitrypsin deficiency

c. Toxins - alcohol / aflatoxin B1 / iron overload / chronic anabolic androgen steroid abuse

d. De-Novo (usually large at presentation)

Prepared by Dr. Sharad Maheshwari

8.7.2023

Updated: 10.7.2023

References:

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6354117/

2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4263631/pdf/radiol.14132361.pdf

3. https://www.wjgnet.com/1007-9327/full/v20/i43/15955.htm