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E-book Hepatocellular Carcinoma
he World Health Organization (WHO) estimates that, worldwide, approximately 900,000 individuals develop each year hepatocellular carcinoma (HCC), the most common form of liver cancer [1]. Overall, 69.8% of all HCC cases occur in males, with a male-to-female ratio of 2.66. Accordingly, HCC is the fifth most frequent incident cancer type in men, the ninth in women, and the sixth in the two sexes combined (Table 1.1). From a geographical perspective, the incidence of HCC shows very wide variations. According to the Global Cancer Observatory (GCO), part of the International Agency for Research on Cancer (IARC), 72.5% of all new cases of HCC occur in Asia, where standardized incidence rates peak to 11.6 cases per 100,000 inhabitants/year. In Africa, HCC is the fourth most common incident cancer, with an 8.8 standardized yearly incidence rate of new cases per 100,000 individuals (Table 1.1). In Oceania, Northern America, and Europe, HCC is less common than in Asia or Africa, with the lowest incidence rate being documented in Europe (5.2 new cases per 100,000 individuals per year) where HCC ranks thir-teenth overall among incident cancer types. With regard to mortality, HCC is, worldwide, the third most common oncologi-cal cause of death: more than 830,000 persons die because of HCC every year. Most of these deaths (69.6%) occur among males, with a peak in mortality rates of 12.9 deaths per 100,000 people per year: HCC is the second cause of oncological deaths in males and the sixth among females (Table 1.1). Deaths caused by HCC are par-ticularly frequent in Asia, where HCC is the second cause of cancer death. HCC mortality is also very frequent in Africa, with a mortality rate of 8.5 deaths per year per 100,000 individuals (HCC is the third cause of oncological deaths in the conti-nent), whereas it is less common in Oceania, Northern America, and Europe, where HCC ranks seventeenth among oncological death causes, with a mortality rate (8.5 deaths per year per 100,000 individuals) 2.4 times lower than that registered in Asia. Prevalence is a statistical parameter that indicates the number of people living, in a specific geographic area and period, after a cancer diagnosis dating back one or more years. The prevalence of cancer patients is strictly related to the frequency (i.e., incidence) and the prognosis (i.e., survival) of the disease, and, to a lesser extent, to various factors like population aging, time trends in cancer incidence and survival [2]. In general, about 5% of the population is living after a diagnosis of all cancer types combined. The number of prevalent cases has increased at an annual mean rate of approximately 3%, an increase largely attributable to long-term survi-vorship of patients with cancers like, among others, breast, prostate and colon-rectum carcinomas [2–4]. Worldwide, it is estimated that 995,000 people are living after a diagnosis of HCC, i.e., 12.8 cases per 100,000 individuals. Most of these prevalent cases are males (69.8%) and from Asia (73.6%) while the proportion ranges from 6.1/100,000 in Latin America and the Caribbean to 15.8/100,000 in Asia.
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