The changing epidemiology of primary liver cancer

Abstract

Purpose of review: In prior decades, liver cancer was viewed as a neoplasm that almost exclusively arose among high-risk populations in low- and middle-income countries. Incidence rates in some high-risk populations, however, have been declining, while rates in low-risk populations have been increasing, reflecting changes in underlying etiology. In this review, we highlight the evolving epidemiology of liver cancer, focusing on recent research and advances.

Recent findings: Efforts to reduce or eliminate the risk associated with major risk factors such as hepatitis B virus (HBV), hepatitis C virus (HCV) and aflatoxin B₁ (AFB₁) have met with some success. As opposed to these favorable trends, the joint epidemics of obesity and diabetes have begun to affect liver cancer rates around the world.

Summary: While there has been progress in combating the effects of some risk factors, the increasing prevalence of others poses a major threat to attempts to tackle the rising incidence of liver cancer globally.

Keywords: Non-alcohol fatty liver disease; aflatoxin; hepatitis B virus; hepatitis C virus; hepatocellular carcinoma; obesity.

Figure 1.

Trends in liver cancer incidence rates in males and females by country, 1978–2012. (Bray F, Colombet M, Mery L, Piñeros M, Znaor A, Zanetti R and Ferlay J, editors. Cancer incidence in five continents, volumes I to XI: IARC CANCERBase No. 11 [Internet], Available at: http://ci5.iarc.fr. Accessed November 20, 2018.)