Abdominal Radiology

, Volume 43, Issue 1, pp 13–25 | Cite as

Epidemiology of hepatocellular carcinoma: target population for surveillance and diagnosis

  • An Tang
  • Oussama Hallouch
  • Victoria Chernyak
  • Aya Kamaya
  • Claude B. Sirlin
Article

Abstract

Hepatocellular carcinoma (HCC) is the sixth most common cancer and the second leading cause of cancer mortality worldwide. Incidence rates of liver cancer vary widely between geographic regions and are highest in Eastern Asia and sub-Saharan Africa. In the United States, the incidence of HCC has increased since the 1980s. HCC detection at an early stage through surveillance and curative therapy has considerably improved the 5-year survival. Therefore, medical societies advocate systematic screening and surveillance of target populations at particularly high risk for developing HCC to facilitate early-stage detection. Risk factors for HCC include cirrhosis, chronic infection with hepatitis B virus (HBV), hepatitis C virus (HCV), excess alcohol consumption, non-alcoholic fatty liver disease, family history of HCC, obesity, type 2 diabetes mellitus, and smoking. Medical societies utilize risk estimates to define target patient populations in which imaging surveillance is recommended (risk above threshold) or in which the benefits of surveillance are uncertain (risk unknown or below threshold). All medical societies currently recommend screening and surveillance in patients with cirrhosis and subsets of patients with chronic HBV; some societies also include patients with stage 3 fibrosis due to HCV as well as additional groups. Thus, target population definitions vary between regions, reflecting cultural, demographic, economic, healthcare priority, and biological differences. The Liver Imaging Reporting and Data System (LI-RADS) defines different patient populations for surveillance and for diagnosis and staging. We also discuss general trends pertaining to geographic region, age, gender, ethnicity, impact of surveillance on survival, mortality, and future trends.

Key words

Review article Hepatocellular carcinoma Epidemiology Risk factors Prevalence Incidence 

Abbreviations

AASLD

American Association for the Study of Liver Diseases

APASL

Asian Pacific Association for the Study of the Liver

EASL-EORTC

European Association for the Study of the Liver-European Organization for Research and Treatment of Cancer

HBV

Hepatitis B virus

HCC

Hepatocellular carcinoma

HCV

Hepatitis C virus

JSH

Japan Society of Hepatology

KLCSG-NCC

Korean Liver Cancer Study Group and the National Cancer Center

LI-RADS

Liver Imaging Reporting and Data System

NAFLD

Non-alcoholic fatty liver disease

NASH

Non-alcoholic steatohepatitis

WHO

World Health Organization

Notes

Compliance with Ethical Standards

Funding

This work was supported by a clinical research scholarship by the Fonds de recherche du Québec—Santé and Fondation de l’association des radiologistes du Québec (Career Award #26993) to An Tang.

Conflict of Interest

An Tang, Victoria Chernyak, Aya Kamaya and Claude B. Sirlin are members of the LI-RADS Steering Committee. Oussama Hallouch declares that he has no conflict of interest. Aya Kamaya receives royalties from Elsevier/Amirsys. Claude B. Sirlin has industry research grants from Bayer, Guerbet, Siemens, GE, Philips, Supersonic, and Arterys and consulting and service agreements with Alexion, AstraZeneca, Bioclinica, BMS, Bracco, Celgene, Fibrogen, Galmed, Genentech, Genzyme, Gilead, Icon, Intercept, Isis, Janssen, NuSirt, Perspectum, Pfizer, Profil, Sanofi, Shire, Synageva, Tobira, Takeda, and Virtual Scopics.

Ethical approval

This article does not contain any studies with human participants performed by any of the authors.

IRB approval

No IRB approval was required for this review article.

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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  1. 1.Department of Radiology, Radio-Oncology and Nuclear MedicineUniversity of Montreal and CRCHUMMontréalCanada
  2. 2.Centre de recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM)MontrealCanada
  3. 3.Department of RadiologyMontefiore Medical CenterBronxUSA
  4. 4.Stanford University Medical CenterStanfordUSA
  5. 5.Liver Imaging Group, Department of RadiologyUniversity of California San DiegoLa JollaUSA

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