ABSTRACT
Hepatocellular carcinoma (HCC) is the fifth most common cancer worldwide, the third most common cause of cancer mortality in men, and the sixth most common in women (1-7). As described in earlier chapters (chaps. 1 and 3), the geographic distribution of HCC varies considerably. Eighty percent of new cases occur in sub-Saharan Africa or Eastern Asia; the Pacific rim and southern Europe are other high-incidence zones. In low-rate countries, such as Australia and the United States, the incidence and mortality of HCC have increased at least twofold in recent decades, largely because of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections (1-8). Despite efforts to improve early diagnosis and treatment, therapeutic options for HCC have not impacted on the mortality. The global health burden of HCC can only be reduced substantially by widespread application of effective prevention programs (9-12).
