ABSTRACT
Hepatocellular carcinoma (HCC), is the most common primary malignancy affecting the liver, accounting for 75% of all liver cancers. Despite rapid advances in knowledge of tumor biology, HCC remains one of the most serious and challenging malignancies in terms of mortality and survival. In the United States, for example, the ratio of liver cancer deaths to new cases was expected to be 0.90, indicating the poor prognosis of this disease and highlighting the need for prevention. The consistent pattern of higher rates in males compared to females suggests that HCC might be influenced by environmental or hormonal factors. Male–female variations in liver cancer incidence may also reflect hormonal influences. Some case-control studies have reported an association between oral contraceptive use in women and the risk of HCC. Hepatitis B virus infection occurs worldwide, but the highest population prevalence of chronic hepatitis B infection is found in Southeast Asia, sub-Saharan Africa, north-central South America, and the North American Arctic.
