tailieunhanh - Chapter 088. Hepatocellular Carcinoma

Hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide. The annual global incidence is about 1 million cases, with a male to female ratio of about 4:1. The incidence rate equals the death rate. In the United States, 19,160 new cases and 16,780 deaths were noted in 2007. | Chapter 088. Hepatocellular Carcinoma Hepatocellular carcinoma HCC is one of the most common malignancies worldwide. The annual global incidence is about 1 million cases with a male to female ratio of about 4 1. The incidence rate equals the death rate. In the United States 19 160 new cases and 16 780 deaths were noted in 2007. The death rate in males in low-incidence countries such as the United States is per 100 000 per year in intermediate-incidence areas such as Austria and South Africa annual death rates range from per 100 000 and in high-incidence areas such as in Asia China and Korea death rates are as high as per 100 000 per year Table 88-1 . The incidence of HCC in the United States is around 3 per 100 000 persons with significant sex ethnic and geographic variations. These numbers are rapidly increasing and may be an underestimate. Around 4 million persons in the United States are chronic carriers of hepatitis C virus HCV . About 10 of them or 400 000 are likely to develop cirrhosis. Around 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 annually seem possible. Future advances in HCC survival will likely depend on immunization strategies for HBV and HCV and earlier diagnosis by screening of patients at risk of HCC development. Table 88-1 Age-Adjusted Incidence Rates for Hepatocellular Carcinoma Persons per 100 000 per Year Country Male Female Argentina Brazil Recife Brazil Sao Paulo Mozambique South Africa Cape Black South Africa Cape White Senegal Nigeria Gambia Burma Japan Korea China Shanghai India Bombay India Madras Great Britain France Italy Varese Norway Spain Navarra Epidemiology Endemic hot spots occur in areas of China and .