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Harrison's Principles of Internal Medicine, 18e
| Part 7. Oncology and Hematology > Section 1. Neoplastic Disorders > |
Chapter 92. Tumors of the Liver and Biliary Tree
Sections: Hepatocellular Carcinoma, Clinical Features, Other Primary Liver Tumors, Further Readings.
Topics Discussed: biliary tract cancer; malignant neoplasm of liver.
Excerpt:"Hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide. The annual global incidence is approximately 1 million cases, with a male to female ratio of approximately 4:1 (1:1 without cirrhosis to 9:1 in many high-incidence countries). The incidence rate equals the death rate. In the United States, approximately 22,000 new cases are diagnosed annually, with 18,000 deaths. The death rates in males in low-incidence countries such as the United States are 1.9 per 100,000 per year; in intermediate areas such as Austria and South Africa, they range from 5.1–20; and in high-incidence areas such as in the Orient (China and Korea) as high as 23.1–150 per 100,000 per year (Table 92–1). The incidence of HCC in the United States is approximately 3 per 100,000 persons, with significant gender, ethnic, and geographic variations. These numbers are rapidly increasing and may be an underestimate. Approximately 4 million chronic hepatitis C virus (HCV) carriers are in the United States alone. Approximately 10% of them or 400,000 are likely to develop cirrhosis. Approximately 5% or 20,000 of these may develop HCC annually. Add to this the two other common predisposing factors—hepatitis B virus (HBV) and chronic alcohol consumption—and 60,000 new HCC cases..."
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