The changing epidemiology of hepatocellular carcinoma in Asia versus United States and Europe

Abstract

<p>Hepatocellular carcinoma (HCC) is a major disease worldwide. There were 782,000 estimated new cases globally<br />in 2012 with the majority (76%) occurring in Asia, especially China. Although the etiologies are similar, the prevalence of<br />each HCC risk factor varies in different geographic regions. In China, hepatitis B virus (HBV) infection is the major cause<br />of HCC, whereas in Japan, US and Europe, hepatitis C virus (HCV) infection predominates. With the epidemic of obesity<br />and diabetes, non-alcoholic fatty liver disease (NAFLD), especially its more aggressive form non-alcoholic steatohepatitis<br />(NASH), has now become a major contributor to HCC. It is anticipated that NAFLD/NASH is likely to overtake viral<br />hepatitis as the leading contributor to HCC in the future. Prior success in reducing HCC cases through hepatitis B<br />immunization program and effective HBV treatments is likely to be offset by rising significance of NASH-associated HCC.<br />In view of this, appropriate measures such as aggressive monitoring clinical course and prognoses of patients with HCC<br />from NASH, studying pathogenesis and mechanism by which NASH promotes HCC, and developing novel intervention and<br />treatment strategy for these patients would be important to address this important public health challenge.</p>