Epidemiology and Risk Factors

Worldwide, hepatocellular carcinoma (HCC) is is the fifth most common cancer in men and the seventh in women (Figure 1). Because of impaired treatment options and late diagnosis in many cases, mortality is almost as high as the incidence rate (mortality: incidence rate 0.93). Worldwide, it is the third most frequent cause of tumour-related deaths. In the year 2008, 748,300 new HCCs and 695,900 deaths have been registered (http://www.iarc.fr/). Almost 85% of all cases occur in the developing countries (Figure 1). Regions with a high incidence are Eastern and South-Eastern Asia and Middle and Western Africa. More than a half of all new HCC are diagnosed in China, resulting in an incidence of 35.2/ 100000 inhabitants. While North America, Australia and Northern Europe belong to the low-incidence areas, the incidence is significantly higher in Southern Europe (10.5 per 100,000) (Figure 2).