ABSTRACT

Hepatocellular carcinoma is one of the most common cancers worldwide with an estimated incidence of 1,000,000 cases per year. The prevalence of HCC has a wide geographical variation but a constant male predominance with a male-to-female ratio of approximately 4:1. Hepatocellular carcinoma is more common in males than females and some investigators have postulated that sex is an independent risk factor, but it is difficult to control for other exposures that tend to be more common in men. The stage of liver disease is thought to influence the risk of HCC. Cirrhosis is staged clinically using the Child’s classification scheme, which measures the degree of liver impairment. The fact that the prevalence of HCC increases with severity of liver disease complicates the decision of when to start screening. Hepatocellular carcinoma exhibits wide biological variation with tumor size doubling times that range from 1 to 19 months. Many radiological techniques have been investigated to improve the diagnostic accuracy of AFP screening.