What are the population characteristics (epidemiology) of HCC?
In the U.S. the highest frequency of HCC occurs in immigrants from Asian countries, where HCC is common. The frequency of HCC among Caucasians is the lowest, whereas among African-Americans and Hispanics, it is intermediate. The frequency of HCC is high among Asians because HCC is closely linked to chronic hepatitis B infection. This is especially so in individuals who have been infected with chronic hepatitis B for most of their lives. If you take a world map depicting the frequency of chronic hepatitis B infection, you can easily superimpose that map on a map showing the frequency of HCC. The initial presentation (symptoms) of HCC in patients in areas of high HCC frequency is quite different from that seen in low frequency areas. Patients from high frequency areas usually start developing HCC in their 40’s, and the cancer is usually more aggressive. That is, the HCC presents with severe symptoms and is inoperable (too advanced for surgery) at the time of diagnosis. Also, in these are
