1. Are Patterns and Prevalence Changing?

  1. Roger Williams CBE, MD, FRCP, FRCS, FMedSci2 and
  2. Simon D. Taylor-Robinson MD, DA, EUMS, FRCP3
  1. Hashem B. El-Serag MD, MPH

Published Online: 29 NOV 2011

DOI: 10.1002/9781119962205.ch1

Clinical Dilemmas in Primary Liver Cancer

Clinical Dilemmas in Primary Liver Cancer

How to Cite

El-Serag, H. B. (2011) Are Patterns and Prevalence Changing?, in Clinical Dilemmas in Primary Liver Cancer (eds R. Williams and S. D. Taylor-Robinson), Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781119962205.ch1

Editor Information

  1. 2

    The Institute of Hepatology London, The Foundation for Liver Research, London, UK

  2. 3

    Department of Medicine, Imperial College London, London, UK

Author Information

  1. Gastroenterology and Hepatology Michael E. DeBakey VA MedicalCenter, Baylor College of Medicine Houston, TX, USA

Publication History

  1. Published Online: 29 NOV 2011
  2. Published Print: 3 DEC 2011

ISBN Information

Print ISBN: 9780470657973

Online ISBN: 9781119962205



  • epidemiology;
  • hepatitis C;
  • hepatitis B;
  • incidence;
  • mortality;
  • diabetes;
  • risk factors;
  • mortality;
  • primary liver cancer;
  • hepatoma


Hepatocellular carcinoma (HCC) accounts for 85–90% of all primary liver cancers. The aetiology of HCC is multiple, with >80% arising in patients with cirrhosis, who have been chronically infected by the hepatitis B virus (HBV) or the hepatitis C virus (HCV). Other risk factors include heavy alcohol drinking, aflatoxin exposure, and recently recognized, diabetes-related and obesity-related non-alcoholic fatty liver disease. The epidemiology of HCC is characterized by several demographic, geographic and temporal variations that can be related to its main risk factors. While the main HCC burden still affects HBV endemic areas in Southeast Asia and sub-Saharan Africa, there have been several reports of an increase in HCV-related HCC in North and South America, as well as in some parts of Europe.