Liver Cancer

Hepatocellular carcinoma (HCC) ranks eighth in frequency among cancers worldwide. The disease has an extremely poor prognosis and is the direct cause of about 1 million deaths annually.23 Hepatocellular carcinoma rates vary widely between countries. High-risk populations are clustered in sub-Saharan Africa and eastern Asia,23 where the reported incidence is 150/100,000 population and the disease accounts for almost 50% of all diagnosed tumors. Approximately 30,000 cases in Europe and 23,000 cases in Japan are diagnosed each year. In the United States, HCC represents less than 2% of all tumors and has an incidence of 1 to 4 cases/100,000 population. The incidence in the United States has risen by 48% during the past 7 years, however, from 15,000 in 1993 to an expected 22,000 in 2000. As the sixth most common malignancy among men and the eleventh most common malignancy among women,23 HCC has a male proponderance, male:female ratios that vary from 0.7:1 in Paraguay to 6.4:1 in the Bas Rhin area of France.23 In the United States the ratio is 2:1. The incidence of HCC increases with age. The median age at diagnosis is 53 years in Asia and 62 years in United States. Studies of emmigrants from areas of high incidence have shown that it may take generations for cancer rates to decrease.65