Risk factors for hepatocellular carcinoma (HCC)

Eighty per cent of cases of hepatocellular carcinoma (HCC) are associated with chronic hepatitis B infection. Most cases of HCC not associated with hepatitis B infection are associated with hepatitis C infection.

Alcoholic cirrhosis and autoimmune chronic active hepatitis also increase the risk of developing HCC.

Several metabolic diseases are also associated with an increased risk for the development of HCC, such as haemochromatosis (iron accumulation), Wilson's disease (copper accumulation), alpha-1-antitrypsin deficiency and glycogen storage diseases.

Alflatoxins are mycotoxins produced by the fungi Aspergillus flavus and Aspergillus parasiticus which contaminate food (e.g. peanuts and corn).

A less common association is with primary biliary cirrhosis which is more typically associated with the subsequent development of cholangiocarcinoma.

Reference

• DeVita VT, Hellman S, Rosenberg SA. Cancer Principles and Practice of Oncology, 5th edn. Philadelphia: Lippincott-Raven.