Hepatocellular carcinoma: Europe's paradox of preventable mortality

Europe has made important advances against hepatocellular carcinoma, which accounts for 75–85% a primary liver cancers, yet incidence and mortality continue to rise. Liver cancer incidence and mortality in Europe increased by around 1% annually between 1990 and 2021, compared with 0·1% globally, and more than 50,000 people a year die from liver cancer in Europe. Around 60% of liver cancers are preventable, yet 5-year survival remains below 20%, despite treatment advances. By contrast, Japan, which has a long-standing national surveillance programme, has reported 5-year survival of around 43%, more than double that in Europe.