by Physicians Weekly | Sep 7, 2010
The incidence of hepatocellular carcinoma (HCC) in the United States has historically been lower than that of other countries, but studies have shown that rates of the disease have increased substantially in recent decades. In addition, primary liver cancer mortality rates have increased faster than mortality rates for any other leading cause of cancer. “It’s important for clinicians to learn about the changing epidemiology of malignancies because this information directly impacts patient care,” says Jennifer C. Obel, MD. Several treatment options are available for patients with early-stage HCC, including resection, transplantation, and liver-directed therapies like chemoembolization (in well-selected patients with localized HCC). However, many patients who are diagnosed with HCC have advanced disease and are only candidates for palliative therapies. “Most HCC is thought to be associated with either chronic hepatitis C virus (HCV) or hepatitis B virus (HBV) infection,” Dr. Obel says. “In the U.S., more than 3 million people are chronically infected with HCV. Chronic infection with HBV is less common overall, but more common among certain ethnic groups.” HCC typically develops in patients with underlying cirrhosis. Commonly reported risk factors for cirrhosis include alcohol-induced liver disease, HCV and HBV infection, obesity, and type 2 diabetes. Assessing Incidence & Survival In the March 2009 issue of the Journal of Clinical Oncology, researchers at the National Cancer Institute examined trends in HCC from 1975 to 2005. The report found that the incidence of HCC tripled in the United States during this time period. Between 2000 and 2005, liver cancer rates increased significantly among African-American, Hispanic, and Caucasian men between the ages of 50 and 59 (Table 1). The...
