1. Incidence Hepatocellular Carcinoma is one of the most common malignancies worldwide More common in Asia and Africa than in the United States. The highest incidence of HCC is in Japan (4-5%). Other high-incidence regions include sub-Saharan Africa. Internationally, the common causes of HCC are hepatitis B, hepatitis C, and aflatoxin exposure Annual global incidence of 1 Million cases Male: Female = 4:1 Incidence rate is equal to the death rate http://emedicine.medscape.com/article/369226-overview Harrison’s Principles of Internal Medicine 17 th ed

2. Incidence Most patients with hepatocellular carcinoma (HCC) die within 1 year after diagnosis. Survival is dependent on tumor size and on associated diseases at the time of diagnosis. Patients with cirrhosis have a shorter survival. Surgical cure is possible in less than 5% of patients. Annual Death Rates in Males Low-incidence countries (US) – 1.9 per 100,000 Intermediate-incidence (Austria and South Africa) – 5.1-20.0 per 100,000 High-incidence (Asia, China, Korea) – 23.1-150 per 100,000 http://emedicine.medscape.com/article/369226-overview Harrison’s Principles of Internal Medicine 17 th ed

3. Incidence Age: Patients with cirrhosis may present earlier. In high-incidence regions of the world (ie, Asia, Africa), patients present at age 30-50 years. In low-incidence regions (ie, Western Hemisphere), patients present at age 70-80 years. United States – 4 Million chronic HCV carriers – 400,000 will likely develop cirrhosis – 20,000 may develop HCC annualy http://emedicine.medscape.com/article/369226-overview Harrison’s Principles of Internal Medicine 17 th ed