Epidemiology

Worldwide, hepatocellular carcinoma (HCC) is the sixth most common cause of cancer and the second leading cause of cancer-related death. The global incidence of HCC varies according to the prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection. Overall, 44% of HCC cases worldwide are attributable to chronic HBV infection, with the majority of cases occurring in Asia.[3]​ An increase in metabolic and behavioural risk factors (e.g., obesity, diabetes, metabolic dysfunction-associated steatotic liver disease, alcohol) is contributing to increasing or stabilising HCC rates in many countries.[4][5]

In the US, liver cancer incidence more than tripled in the past four decades; the incidence has stabilised in men since 2015 but continues to increase in women by 2% every year.[6] HCC is the most common type of liver cancer and accounts for 70% to 86% of cases.[6][7]​ The age distribution of HCC in the US has shifted toward younger ages, with a proportional increase in those aged 45-60 years.[8]​ In 2012, the age-adjusted incidence of HCC in the US was 6.7 per 100,000.[9] In the EU, the estimated incidence of liver cancer in 2022 was 19.5 per 100,000 in men and 7.2 per 100,000 in women.[10]​ In the UK, there are about 6600 new cases of liver cancer each year, corresponding to an incidence of about 10 per 100,000 people.[11]​

The incidence of HCC is 2-3 times higher among men than in women in most countries, which may be due to sex-specific prevalence of risk factors including the trophic effects of androgens.[4]​[12]​​[13][14]​ Mean age at diagnosis of HCC is 60 years in the US and Europe, 50-60 years in Asia, and 46 years in Africa.[8][15]​​​​​​​​[16]

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