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What is Liver Cancer Hepatocellular carcinoma

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Slide 1 - ppt slide no 1 content not found
Slide 2 - Primary liver cancer is the fifth most common cancer in the world and the third most common cause of cancer mortality Hepatocellular carcinomas (HCCs) are malignant tumors of liver parenchymal cells
Slide 3 - 1.3% of estimated incident cancer cases are in the liver and intrahepatic bile duct Incidence rates are higher for males than females (2-4:1) Higher incidence for African Americans and Asians than whites 5 year survival rate is approximately 6.9%
Slide 4 - One of the most common malignancies in eastern Asia and sub-Saharan Africa Incidence up to 90.0/100,000 in some parts of the world More than 600,000 deaths in 2002 44% of the world’s cases occur in China
Slide 5 - Incidence increases with age then plateaus when the peak is reached, around 55 to 65 in the United States Ethnic and familial clustering have been reported Possible interaction between Hepatitis infection and a major gene
Slide 6 - Implicated as the probable cause of HCC in at least 80% of cases worldwide About 5% of the world’s population(350 million people) is chronically infected with HBV Lifetime risk of HCC for these individuals is estimated at 10-25%
Slide 7 - In low prevalence areas (such as the U.S.), is spread mainly by exposure to contaminated blood through IV drug use or sexual contact with an HBV carrier In highly endemic areas of Asia, about half of chronic infections result from perinatal transmission Can also be transmitted through household contacts, contaminated blood or blood products, organ transplantation, or needle-stick
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Slide 9 - Areas of the world with high mortality rates for HCC also have high HBV infection rates Cirrhosis is closely related with chronic HBV infection, at least 80% of liver cancers occur in cirrhotic livers Case control studies in all regions of the world have shown that chronic HBV infection is much more common in HCC cases than controls OR ranged from 5:1 to 65:1 Prospective studies of chronic HBV carriers have shown very high relative risks for HCC 400 and 500 /100,000 compared with 5/100,000 Prevention of HBV reduces risk of subsequent HCC
Slide 10 - Viral DNA is integrated into host cell genome HBV sequences are present in HCCs One gene may have important promotional role in hepatocarcinogenesis, but the mechanism is not yet known
Slide 11 - Vaccination 90% preventable with proper use of hepatitis B vaccine Universal immunization of newborns in Taiwan is associated with at least a 50% reduction in incidence of HCC among adolescents Part of WHO universal childhood vaccination Cost reduced from $100 to $1 per pediatric dose
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Slide 13 - Major viral cause of liver cancer in areas with low HBV prevalence About 3% of the world’s population (170 million people) is chronically infected with HCV 3-4 million new infections each year 2-4% with chronic HCV develop HCC
Slide 14 - Transmitted by parenteral route Intravenous drug use Hemodialysis Blood transfusion Exposure to blood of infected patient Other routes probably exist but have not been identified
Slide 15 - Many epidemiological studies have indicated association Detection of HCV RNA in tumor and nontumor cirrhotic liver tissue of patients with HCC
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Slide 17 - Alcohol is a significant risk factor for liver cancer in areas with low HBV and HCV incidence Evidence indicates that alcohol causes cirrhosis which in turn increases risk of HCC In high incidence areas, alcohol may exacerbate viral liver damage and promote tumor development
Slide 18 - Aflatoxins Thorotrast (X-ray contrast material) Vinyl Chloride Steroid Hormones Schistosomiasis Liver flukes Iron Tobacco Diet
Slide 19 - Cirrhosis Immune Function Genetic Susceptibility Hemochromatosis Other Inherited Metabolic Disease Diabetes Mellitus Non-alcoholic Steatohepatitis Primary Sclerosing Cholangitis
Slide 20 - Limit exposure of the general populations and workers in certain industries to hepatocarcinogens Reduce transmission of hepatitis by IV drug use through counseling about risks Prevent HBV infection (vaccination)
Slide 21 - Serum alpha-fetoprotein (AFP) Limitations: Senstitivity and specificity Ultrasonography of the liver Limitations Quality of equipment Skill of operator in identifying small tumors Cost
Slide 22 - Vaccine for HCV Understand molecular pathogenesis of HCC New targets for chemoprevention of HCC and therapies for established HCC
Slide 23 - 80-95% of HCCs are associated with chronic infection with Hepatitis B or C HBV infection is preventable by immunization and HCV is preventable through public health measures If opportunities for intervention are acted upon, HCC could become a minor cause for cancer mortality in the future
Slide 24 - Cancer Epidemiology, 3rd ed. 2006. Oxford University Press Centers for Disease Control American Cancer Society