| Theme |
Algorithm for Diagnosis and Treatment of Liver Cancer |
| Title |
Risk Factors for Hepatocellular Carcinoma and Definition of High Risk Populations : Hepatocellular Carcinoma with Hepatitis C Virus-related Chronic Liver Disease |
| Author |
Shingo Nakamoto |
Medicine and Clinical Oncology, Graduate School of Medicine, Chiba University |
| Author |
Fumio Imazeki |
Medicine and Clinical Oncology, Graduate School of Medicine, Chiba University |
| Author |
Tatsuo Kanda |
Medicine and Clinical Oncology, Graduate School of Medicine, Chiba University |
| Author |
Osamu Yokosuka |
Medicine and Clinical Oncology, Graduate School of Medicine, Chiba University |
| [ Summary ] |
Hepatitis C virus (HCV) infection accounts for about 80% of hepatocellular carcinoma (HCC) cases in Japan. The rate of HCC incidence in Japan is higher than in Western countries. In Japan, HCC accounts for 1-2% per year in patients without cirrhosis while 5-7% per year in patients with cirrhosis. In HCV-infected patients, risk factors for HCC development can be divided into three categories ; host related, viral related, and environmental factors. Host related and environmental factors include old age (old age at infection) male gender, advanced liver fibrosis, higher activity of liver disease, heavy alcohol intake (over 50-60 g/day), diabetes mellitus, and obesity. Viral factors associated with HCC risk include HBV co-infection, whereas the effect of viral load, genotype, or quasispecies of HCV is unclear. Antiviral therapy reduces the risk for HCC, especially in patients for whom viral eradication is possible. Based on the Evidence-Based Clinical Practice Guidelines of HCC published by the Japan Society of Hepatology, patients with chronic hepatitis C are defined as a high risk population for HCC, while patients with HCV-related cirrhosis are defined as a super high risk population. |