Epidemiology of hepatocellular carcinoma: target population for surveillance and diagnosis

Abstract

Hepatocellular carcinoma (HCC) is the sixth most common cancer and the second leading cause of cancer mortality worldwide. Incidence rates of liver cancer vary widely between geographic regions and are highest in Eastern Asia and sub-Saharan Africa. In the United States, the incidence of HCC has increased since the 1980s. HCC detection at an early stage through surveillance and curative therapy has considerably improved the 5-year survival. Therefore, medical societies advocate systematic screening and surveillance of target populations at particularly high risk for developing HCC to facilitate early-stage detection. Risk factors for HCC include cirrhosis, chronic infection with hepatitis B virus (HBV), hepatitis C virus (HCV), excess alcohol consumption, non-alcoholic fatty liver disease, family history of HCC, obesity, type 2 diabetes mellitus, and smoking. Medical societies utilize risk estimates to define target patient populations in which imaging surveillance is recommended (risk above threshold) or in which the benefits of surveillance are uncertain (risk unknown or below threshold). All medical societies currently recommend screening and surveillance in patients with cirrhosis and subsets of patients with chronic HBV; some societies also include patients with stage 3 fibrosis due to HCV as well as additional groups. Thus, target population definitions vary between regions, reflecting cultural, demographic, economic, healthcare priority, and biological differences. The Liver Imaging Reporting and Data System (LI-RADS) defines different patient populations for surveillance and for diagnosis and staging. We also discuss general trends pertaining to geographic region, age, gender, ethnicity, impact of surveillance on survival, mortality, and future trends.

Prognostic value of aspartate aminotransferase to platelet ratio index as a noninvasive biomarker in patients with hepatocellular carcinoma: a meta-analysis

“…Despite great advances in early diagnosis and treatments, the prognosis, especially the long-term survival, remains dissatisfactory in patients with HCC 3–6. Additionally, the prognostic markers of HCC have not been completely elucidated.…”

Hepatocellular Carcinoma‐Associated Protein TD26 Interacts and Enhances Sterol Regulatory Element‐Binding Protein 1 Activity to Promote Tumor Cell Proliferation and Growth

“…Hepatocellular carcinoma (HCC) is the most common primary malignancy of liver cancer with a high global prevalence. Although HCC is the sixth‐most common cancer, it ranks as the second‐leading cause of cancer‐related death worldwide attributed to its poor prognosis . After stage evaluation, only 20% patients with early‐stage HCC are eligible for potentially curative treatment, including liver resection, transplantation, and local ablation, which commonly leads to promising 5‐year survival rates up to 75% .…”

Identifying Differentially Expressed MicroRNAs Between Cirrhotic and Non-Cirrhotic Hepatocellular Carcinoma and Exploring Their Functions Using Bioinformatic Analysis

“…However, HCC surveillance is not properly conducted and requires improvement [50,51]. Selecting a target patient group instead of all patients for surveillance may be a suitable strategy, but few studies have been designed to obtain such a criterion [52]. In our study, we successfully determined that HCC patients with different expressions of miRNAs would present with different prognosis.…”