Liver cancer (also known as hepatic cancer, primary hepatic cancer, or primary hepatic malignancy) is cancer that starts in the liver. Liver cancer can be primary (starts in liver) or secondary (meaning cancer which has spread from elsewhere to the liver, known as liver metastasis). Liver metastasis is more common than that which starts in the liver. Liver cancer is increasing globally.

Primary liver cancer is globally the sixth-most frequent cancer and the fourth-leading cause of death from cancer. In 2018, it occurred in 841,000 people and resulted in 782,000 deaths. Higher rates of liver cancer occur where hepatitis B and C are common, including Asia and sub-Saharan Africa. Males are more often affected with HCC than females Diagnosis is most frequent among those 55 to 65 years old.

The leading cause of liver cancer is cirrhosis due to hepatitis B, hepatitis C or alcohol. Other causes include aflatoxin, non-alcoholic fatty liver disease and liver flukes. The most common types are hepatocellular carcinoma (HCC), which makes up 80% of cases and intrahepatic cholangiocarcinoma. The diagnosis may be supported by blood tests and medical imaging, with confirmation by tissue biopsy.

Causes and Risk Factors :

Viral infection

Viral infection with hepatitis C virus (HCV) or Hepatitis B virus (HBV) is the chief cause of liver cancer in the world today, accounting for 80% of hepatocellular carcinoma (HCC). Men with chronic HCV or HBV are more likely to develop hepatocellular carcinoma than women with chronic HCV or HBV; however, the reasons for this gender difference is unknown. HBV infection is also linked to cholangiocarcinoma. The role of viruses other than HCV or HBV in liver cancer is much less clear, even though there is some evidence that co-infection of HBV and hepatitis D virus may increase the risk for HCC.

Cirrhosis

In addition to virus-related cirrhosis described above, other causes of cirrhosis can lead to HCC. Alcohol intake correlates with risk of HCC, and the risk is far greater in individuals with an alcohol-induced cirrhotic liver. There are a few disorders that are known to cause cirrhosis and lead to cancer, including hereditary hemochromatosis and primary biliary cirrhosis.

Aflatoxin

Aflatoxin exposure can lead to the development of HCC. The aflatoxins are a group of chemicals produced by the fungi Aspergillus flavus (the name comes from A. flavus toxin) and A. parasiticus. Food contamination by the fungi leads to ingestion of the chemicals, which are very toxic to the liver. Common foodstuffs contaminated with the toxins are cereals, peanuts, and other vegetables.

Nonalcoholic steatohepatitis (NASH) and Nonalcoholic fatty liver (NAFL)

NASH and NAFL is beginning to be called a risk factor for liver cancer, particularly HCC In recent years, there has been a noted increase in liver transplantations for HCC that was attributable to NASH. More research is needed in this area and NASH/NAFL

Journal of Cancer Diagnosis is an open access peer-reviewed journal dealing with articles on different aspects of Physical exam, Laboratory tests, Imaging tests, Biopsy, Breast Cancer Diagnosis, Mammogram and breast ultrasound, Biopsy, Magnetic resonance imaging (MRI), Tumour biomarkers, Lung Cancer Diagnosis, Imaging tests, Sputum cytology, Tissue biopsy, Ovarian Cancer Diagnosis, Imaging tests, Blood test, Surgery, Tumour markers, tide specific antigen (TPS), Neuron specific enolase (NSE), Carcino Embryonic antigen (CEA), Liver Cancer Diagnosis, etc.

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