Update in global trends and aetiology of hepatocellular carcinoma

Abstract

Hepatocellular carcinoma (HCC) is the most common primary cancer of the liver responsible for an increasing number of cancer-related deaths, especially in developing economies of Asia and Africa. A plethora of risk factors have been described in the literature. Some of the important ones include chronic viral hepatitis, liver cirrhosis, environmental toxins such as aflatoxin, non-alcoholic fatty liver disease, lifestyle factors like alcohol consumption, smoking, and dietary factors, metabolic diseases like diabetes mellitus and obesity, and genetic and hereditary disorders. The development of HCC is complex involving sustained inflammatory damage leading to hepatocyte necrosis, regeneration, and fibrotic deposition. It also poses multiple challenges in diagnosis and treatment despite advances in diagnostic, surgical, and other therapeutic advancements. This is a narrative review of findings of multiple studies that were retrieved from electronic databases like PubMed, MEDLINE, Embase, Google Scholar, Scopus, and Cochrane. We summarise the current knowledge regarding the epidemiology and various risk factors for the development of HCC with a brief note on various prevention strategies.

Keywords: HBV; HCC; aetiology; epidemiology; hepatitis C; hepatocellular carcinoma; incidence; mortality; prevalance; risk factors.

Fig. 1

Estimated age-standardised rates of incident cases, both sexes, liver cancer, worldwide in 2018

Fig. 2

Estimated age-standardised incidence and mortality rates (World) in 2018, liver, both sexes, all ages

Fig. 3

Estimated number of incident cases and deaths from 2018 to 2040, liver, both sexes, all ages

Fig. 4

Recent trends in incidence rates (2000–2015) of liver and intrahepatic bile duct cancer by race and ethnicity in both sexes and all ages