Risk factors for hepatocellular carcinoma in HCV-cirrhosis: What we know and what is missing

Hepatocellular carcinoma (HCC) is a major health problem, being the fifth most common cancer worldwide with 626,000 new cases in 2002 [1]. The incidence and absolute mortality of HCC is increasing in Europe and the United States [2], and is currently the leading cause of death amongst cirrhotic patients [3,4]. Improvement of the overall outcome of these patients will come from prevention policies, early detection programs and advancement in the efficacy of therapies. Identification of the at-risk populations is particularly crucial to implement efficient prevention policies, and to engage the adequate populations in cost-effective surveillance programs.