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      Epidemiology of Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma

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          Abstract

          Hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC) are the most frequently occurring types of primary liver cancer and together are among the most common incident cancers worldwide. There are a number of modifiable and nonmodifiable HCC and ICC risk factors that have been reported. A review of the existing literature the epidemiology and risk factors for HCC and ICC was performed. There are a number of major infectious, lifestyle, metabolic, and heritable risk factors for both HCC and ICC. Some of these risk factors are either potentially preventable (eg, alcohol and tobacco use) or are currently treatable (eg hepatitis infection). In most cases, the molecular pathway or mechanism by which these etiologic factors cause primary liver cancer has not been well delineated. However, in nearly all cases, it is believed that a given risk factor causes liver injury and inflammation which results in chronic liver disease. Given the rising prevalence of several common HCC and ICC risk factors in the western world, the best opportunities for improving the care of these patients are either through the prevention of modifiable risk factors that are associated with the development of chronic liver disease or the identification of at risk patients, ensuring they are appropriately screened for the development of primary liver cancer, and initiating treatment early.

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          Most cited references64

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          Type 2 diabetes and cancer: umbrella review of meta-analyses of observational studies.

          To summarise the evidence and evaluate the validity of the associations between type 2 diabetes and the risk of developing or dying from cancer.
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            The association between diabetes and hepatocellular carcinoma: a systematic review of epidemiologic evidence.

            We conducted a systematic review and a meta-analysis to estimate the magnitude and determinants of association between diabetes and hepatocellular carcinoma (HCC). MEDLINE searches were conducted for published full studies (between January 1966 and February 2005) that provided risk estimates and met criteria concerning the definition of exposure and outcomes. Two investigators independently performed standardized search and data abstraction. Unadjusted and adjusted odds ratios for individual outcomes were obtained or calculated for each study and were synthesized using a random-effects model. A total of 26 studies met our inclusion and exclusion criteria. Among 13 case-control studies, diabetes was associated significantly with HCC in 9 studies (pooled odds ratio, 2.5; 95% confidence interval, 1.8-3.5). Among 13 cohort studies, diabetes was associated significantly with HCC in 7 studies (pooled risk ratio, 2.5; 95% confidence interval, 1.9-3.2). The results were relatively consistent in different populations, different geographic locations, and a variety of control groups. The significant association between HCC and diabetes was independent of alcohol use or viral hepatitis in the 10 studies that examined these factors. Few studies adjusted for diet and obesity. Diabetes is associated with an increased risk for HCC. However, more research is required to examine issues related to the duration and treatment of diabetes, and confounding by diet and obesity.
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              Hepatocellular Carcinoma in the Absence of Cirrhosis in United States Veterans is Associated With Nonalcoholic Fatty Liver Disease.

              Hepatocellular carcinoma (HCC) can develop in individuals without cirrhosis. We investigated risk factors for development of HCC in the absence of cirrhosis in a U.S.
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                Author and article information

                Journal
                Cancer Control
                CCX
                spccx
                Cancer Control : Journal of the Moffitt Cancer Center
                SAGE Publications (Sage CA: Los Angeles, CA )
                1073-2748
                1526-2359
                07 September 2017
                September 2017
                : 24
                : 3
                : 1073274817729245
                Affiliations
                [1 ]U.S. Department of Veterans Affairs Health Services Research and Development Center of Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
                [2 ]Michael E. DeBakey Department of Surgery, Michael E. DeBakey VA Medical Center, Baylor College of Medicine, Houston, TX, USA
                [3 ]Department of Medicine, Baylor College of Medicine, Houston, TX, USA
                Author notes
                [*]Nader N. Massarweh, Michael E. DeBakey Department of Surgery, Michael E. DeBakey VA Medical Center, Baylor College of Medicine, 2002 Holcombe Boulevard, OCL 112, Houston, TX 77030, USA. Email: massarwe@ 123456bcm.edu
                Article
                10.1177_1073274817729245
                10.1177/1073274817729245
                5937247
                28975830
                4c6ae9ae-5e2c-4312-84c7-52f672339c4a
                © The Author(s) 2017

                This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                : 12 September 2016
                : 14 March 2017
                Categories
                Review
                Custom metadata
                September 2017

                epidemiology,cirrhosis,hepatitis,hepatocellular carcinoma,intrahepatic cholangiocarcinoma

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