Liver Cancer (cont.)

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What are the population characteristics (epidemiology) of liver cancer?

In the U.S., the highest frequency of liver cancer occurs in immigrants from Asian countries, where liver cancer is common. The frequency of liver cancer among Caucasians is the lowest, whereas among African-Americans and Hispanics, it is intermediate. The frequency of liver cancer is high among Asians because liver cancer is closely linked to chronic hepatitis B infection. This is especially so in individuals who have been infected with chronic hepatitis B for most of their lives (it is usually a childhood disease in Asia). If you take a world map depicting the frequency of chronic hepatitis B infection, you can easily superimpose that map on a map showing the frequency of liver cancer. On the other hand, in Japan, North America and Europe, hepatitis C infection is a much more common cause; alcohol abuse is also an important contributing factor. All of these diseases cause continual damage to the liver, which can result in severe scarring (cirrhosis) that then can lead to cancer.

In areas where liver cancer is more common and associated with hepatitis B, the cancer usually develops in people in their 30s and 40s, as opposed to other areas of the world, where they are in their 60s and 70s. This is because it generally takes about 30 years of chronic damage to the liver before the cancer grows large enough to become obvious. Men are much more likely than women to have liver cancer, especially if they have hepatitis and cirrhosis. Regardless of the cause, patients with a history of alcohol abuse as well are much sicker when they initially develop the cancer. In North America, up to one-quarter of people with liver cancer have no obvious risk factors; they are generally healthier and do much better with treatment.


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