scholarly journals Epidemiology of Hepatocellular Carcinoma

2000 ◽  
Vol 14 (8) ◽  
pp. 703-709 ◽  
Author(s):  
Mimi C Yu ◽  
Jian-Min Yuan ◽  
Sugantha Govindarajan ◽  
Ronald K Ross

Although rare in Canada and the United States, hepatocellular carcinoma (HCC) ranks as the eighth most common cancer in the world. High-risk regions are East and Southeast Asia, and sub-Saharan Africa. Independent of race and geography, rates in men are at least two to three times those in women; this sex ratio is more pronounced in high-risk regions. Rates of HCC in the United States have increased by 70% over the past two decades. Registry data in Canada and Western Europe show similar trends. In contrast, the incidence of HCC in Singapore and Shanghai, China, both high-risk regions, has declined steadily over the past two decades. Among white and black Americans, there is an inverse relationship between social class status and HCC incidence. Chronic infection by the hepatitis B virus (HBV) is by far the most important risk factor for HCC in humans. It is estimated that 80% of HCC worldwide is etiologically associated with HBV. In the United States, although the infection rate in the general population is low, HBV is estimated to account for one in four cases of HCC among non-Asians. Chronic infection by the hepatitis C virus is another important risk factor for HCC in the United States; however, this virus is believed to play a relatively minor role in the development of HCC in Africa and Asia. Dietary aflatoxin exposure is an important codeterminant of HCC risk in Africa and parts of Asia. In Canada and the United States, excessive alcohol intake, cigarette smoking and oral contraceptive use in women also are risk factors for HCC.

2014 ◽  
Vol 8 ◽  
pp. CMO.S9926 ◽  
Author(s):  
Avegail Flores ◽  
Jorge A. Marrero

Hepatocellular carcinoma (HCC) is one of the most common tumors worldwide and one of the deadliest. Patients with chronic liver disease are at the highest risk for developing this tumor. This link provides an opportunity for developing preventive strategies and surveillance that aims at early detection of this tumor and possibly improving outcomes. In this review, we will discuss the latest developments in surveillance strategies, diagnosis, and treatment of this tumor. HCC is the sixth most common cancer in the world, with 782,000 new cases occurring in 2012 worldwide. In 2012, there were 746,000 deaths from liver cancer. HCC is the third most fatal cancer in the world. The distribution of HCC, which varies geographically, is related to the prevalence of hepatotropic virus. The burden of the disease is the highest in Eastern Asia, sub-Saharan Africa, and Melanesia where hepatitis B (HBV) infection is endemic. Meanwhile, in Japan, United States, and Europe, hepatitis C (HCV) infection is prevalent, and subsequently, is the major risk factor for acquiring HCC in these regions. 1 , 3 It is estimated that the incidence of HCC in Europe and United States will peak at 2020—there will be 78,000 new HCC cases in Europe and 27,000 in the United States—and decline thereafter. 1 Indeed, in Japan, the incidence of HCC had already plateaued and started to slowly fall. 4 Cirrhosis is the most important risk factor for HCC regardless of etiology and may be caused by chronic viral hepatitis (mainly HBV and HCV), alcoholic liver disease, autoimmune disease, Stage 4 primary biliary cirrhosis, and metabolic diseases such as hereditary hemochromatosis, alpha-1 antitrypsin deficiency, and non-alcoholic fatty liver disease. In the Western hemisphere, HCC occurs in a background of cirrhosis in 90% of the cases. 5 Before concentrating on diagnosis and therapeutics, it is important to discuss surveillance for this tumor.


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Eman Mahmoud Fathy Barakat ◽  
Khalid Mahmoud AbdAlaziz ◽  
Mohamed Mahmoud Mahmoud El Tabbakh ◽  
Mohamed Kamal Alden Ali

Abstract Background Hepatocellular carcinoma (HCC) is the most common primary liver malignancy and is a leading cause of cancer-related death worldwide. In the United States, HCC is the ninth leading cause of cancer deaths. Despite advances in prevention techniques, screening, and new technologies in both diagnosis and treatment, incidence and mortality continue to rise. Cirrhosis remains the most important risk factor for the development of HCC regardless of etiology. Hepatitis B and C are independent risk factors for the development of cirrhosis. Alcohol consumption remains an important additional risk factor in the United States as alcohol abuse is five times higher than hepatitis C. Diagnosis is confirmed without pathologic confirmation. Screening includes both radiologic tests, such as ultrasound, computerized tomography, and magnetic resonance imaging, and serological markers such as αfetoprotein at 6-month interval. Aim To compare characteristics and behavior of Hepatocellular carcinoma (HCC) in chronic HCV patients and HVB patients Patients and Methods The current study was conducted on patients with de HCC presented at HCC clinic, Tropical medicine department Ain Shams University Hospitals between December 2017 and D ecember 2018, aged (18-70 years old) . Results eline characteristics of study population shown in Table 1 at enrolment, including gender, Education status, co-morbidity, underlying presence or absence of cirrhosis, Child-Pugh class of patients infected with viral hepatitis, and alpha-fetoprotein levels. Male proportion observed to be predominant in both HCV (62%) and HBV (75.4%) infected HCC population. Overall prevalence of HCV and HBV in patients having HCC was 65.95% and 34.04%, respectively. Presence of underlying liver cirrhosis was more significantly associated with HCV seropositives as compared to HBV seropositive patients (p0.05). Table 2 shows comparison of means between HCV and HBV seropositive patients with HCC. In univariate analysis, mean age difference (11.6 years), and total bilirubin levels (-1.91mg/dl) were the only statistically significant observations noted among HCV-HCC group (p = 0.05) Conclusion Hepatocellular carcinoma is mainly caused by Hepatitis C and Hepatitis B viruses, but latter showed predominance, comparatively worldwide and correlated HBV directly as a cause of HCC rather than HCV whose relation with HCC is still unclear (Shepard et al., 2006; Di Bisceglie, 2009). Because of the geographical differences and risk factors, the epidemiological burden of HCV and HBV has been observed different in different areas of the world. In developing countries due to high burden of HCV infection as compared to HBV such as in Taiwan (HCV 17.0%, HBV 13.8%) (Kao et al., 2011), Guam (HCV 19.6%, HBV 18%) (Haddock et al., 2013), and Pakistan (HCV 4.8%, HBV 2.5%) (Rehman et al., 1996; Raza et al., 2007; Qureshi et al., 2010; Butt et al., 2012;) will possibly


2006 ◽  
Vol 4 (8) ◽  
pp. 751-757 ◽  
Author(s):  
Laura M. Kulik

Chronic inflammation induced by viral infections and their role in carcinogenesis is well recognized. Two hepatotropic viruses, hepatitis B and hepatitis C (HCV), have been linked worldwide to the development of hepatocellular carcinoma (HCC). Although orthotopic liver transplant offers the best chance for cure and long-term survival, the demand for organs far outweighs the supply. The incidence of HCC in the United States has increased over the past 3 decades. HCV-induced cirrhosis is believed to play a significant role in the rising rate of HCC. Therefore, primary measures to prevent HCC in HCV-infected patients are urgently needed. Numerous studies of the HCV HCC patient have considered primary treatment with interferon-based therapy. However, secondary prevention currently seems to carry more promise. This article evaluates and assesses various treatments for primary and secondary chemoprevention in the setting of HCV.


2013 ◽  
Vol 8 (2) ◽  
pp. 84-95
Author(s):  
Joann E. Lee ◽  
Miniard Culpepper ◽  
Rhona Julien

The prevalence of unintentional injury and violent behavior among school aged youth in Boston compared to the rest of the country is quite similar. And in the past decade, in spite of attempts both locally and nationally to stymie these behaviors, there has been no change in prevalence. Moreover, such behaviors are the leading cause of death and disability among youth and adults in the United States. This paper will discuss the strategies that have been employed by Pleasant Hill Baptist Church, Boston, MA in response to this trend and will focus on high-risk youth, especially those involved with gangs.


Author(s):  
Ella Inglebret ◽  
Amy Skinder-Meredith ◽  
Shana Bailey ◽  
Carla Jones ◽  
Ashley France

The authors in this article first identify the extent to which research articles published in three American Speech-Language-Hearing Association (ASHA) journals included participants, age birth to 18 years, from international backgrounds (i.e., residence outside of the United States), and go on to describe associated publication patterns over the past 12 years. These patterns then provide a context for examining variation in the conceptualization of ethnicity on an international scale. Further, the authors examine terminology and categories used by 11 countries where research participants resided. Each country uses a unique classification system. Thus, it can be expected that descriptions of the ethnic characteristics of international participants involved in research published in ASHA journal articles will widely vary.


Crisis ◽  
2020 ◽  
pp. 1-5
Author(s):  
Shannon Lange ◽  
Courtney Bagge ◽  
Charlotte Probst ◽  
Jürgen Rehm

Abstract. Background: In recent years, the rate of death by suicide has been increasing disproportionately among females and young adults in the United States. Presumably this trend has been mirrored by the proportion of individuals with suicidal ideation who attempted suicide. Aim: We aimed to investigate whether the proportion of individuals in the United States with suicidal ideation who attempted suicide differed by age and/or sex, and whether this proportion has increased over time. Method: Individual-level data from the National Survey on Drug Use and Health (NSDUH), 2008–2017, were used to estimate the year-, age category-, and sex-specific proportion of individuals with past-year suicidal ideation who attempted suicide. We then determined whether this proportion differed by age category, sex, and across years using random-effects meta-regression. Overall, age category- and sex-specific proportions across survey years were estimated using random-effects meta-analyses. Results: Although the proportion was found to be significantly higher among females and those aged 18–25 years, it had not significantly increased over the past 10 years. Limitations: Data were self-reported and restricted to past-year suicidal ideation and suicide attempts. Conclusion: The increase in the death by suicide rate in the United States over the past 10 years was not mirrored by the proportion of individuals with past-year suicidal ideation who attempted suicide during this period.


2013 ◽  
Vol 10 (2) ◽  
pp. 115-124
Author(s):  
Philip L. Martin

Japan and the United States, the world’s largest economies for most of the past half century, have very different immigration policies. Japan is the G7 economy most closed to immigrants, while the United States is the large economy most open to immigrants. Both Japan and the United States are debating how immigrants are and can con-tribute to the competitiveness of their economies in the 21st centuries. The papers in this special issue review the employment of and impacts of immigrants in some of the key sectors of the Japanese and US economies, including agriculture, health care, science and engineering, and construction and manufacturing. For example, in Japanese agriculture migrant trainees are a fixed cost to farmers during the three years they are in Japan, while US farmers who hire mostly unauthorized migrants hire and lay off workers as needed, making labour a variable cost.


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