Epidemiology of Hepatocellular Carcinoma.
Epidemiology of Hepatocellular Carcinoma.
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DOI：
10.1002/hep.31288
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发表时间：
2021-01
期刊：
影响因子：
--
通讯作者：
El-Serag HB
中科院分区：
文献类型：
--
作者：
McGlynn KA;Petrick JL;El-Serag HB
肝癌是世界癌症负担的一个主要因素，近几十年来，许多国家的发病率有所增加。作为肝癌的主要组织学类型，肝细胞癌（HCC）是绝大多数肝癌诊断和死亡的原因。目前，乙型肝炎病毒（HBV）和丙型肝炎病毒（HCV）仍然是HCC最重要的全球危险因素，但在未来几年，它们的重要性可能会下降。新生儿乙肝疫苗接种的效果已经在一些国家的年轻人中看到，随着接种人群年龄的增长，这种效果将更加显著。此外，对HBV和HCV慢性感染的有效治疗应有助于降低病毒相关性HCC的发生率。不幸的是，HCC的代谢危险因素，包括代谢综合征、肥胖、2型糖尿病和非酒精性脂肪性肝病（NAFLD）的患病率正在增加，并可能共同成为全球HCC的主要原因。过度饮酒也仍然是一个棘手的风险因素，世界上一些地区的粮食作物受到黄曲霉毒素污染也是如此。虽然肝癌的早期诊断和更好的治疗当然需要大量的努力，但旨在降低患病率、肥胖和糖尿病以及控制霉菌毒素生长的初级预防工作也同样迫切需要。
Liver cancer is a major contributor to the world’s cancer burden and incidence rates have increased in many countries in recent decades. As the principal histologic type of liver cancer, hepatocellular carcinoma (HCC) is responsible for the great majority of liver cancer diagnoses and deaths. Hepatitis B virus (HBV) and hepatitis C virus (HCV) remain, at present, the most important global risk factors for HCC, but it is likely their importance will decline in the coming years. The effect of HBV vaccination of newborns, already seen in young adults in some countries, will be more notable as vaccinated cohorts age. In addition, effective treatments for chronic infections with both HBV and HCV should contribute to declines in the rates of viral-associated HCC. Unfortunately, the prevalence of metabolic risk factors for HCC, including metabolic syndrome, obesity, type II diabetes and non-alcoholic fatty liver disease (NAFLD) are increasing and may jointly become the major cause of HCC globally. Excessive alcoholic consumption also remains an intractable risk factor, as does aflatoxin contamination of food crops in some parts of the world. While significant efforts in early diagnosis and better treatment are certainly needed for HCC, primary prevention efforts aimed at decreasing the prevalence and obesity and diabetes and controlling mycotoxin growth, and are just as urgently required.
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