Hepatocellular carcinoma: updates in primary prevention.

Hepatocellular carcinoma is a significant cause of mortality worldwide and a growing problem in the United States. Treatment options are often limited, and median survival is less than 1 year. Thus, prevention may provide the best opportunity to alter the natural history of this disease. Primary prevention is best exemplified by the successes of such public health measures as universal hepatitis B vaccination. Such antiviral therapies as interferon may also have a role. Lessons can be learned from complementary and alternative medicine. Nevertheless, more work is needed in understanding hepatocarcinogenesis and in developing models to assess potential chemopreventive agents.