Hepatocellular carcinoma: New and emerging risks.

The underlying liver diseases that put patients at risk for the development of hepatocellular carcinoma (HCC) are well known. However, it is equally well known that not all patients with these conditions will develop HCC. Therefore within the disease groups (hepatitis B, cirrhosis, etc.,) there are other factors that indicate greater or lesser risk. Some markers of risk are common to all causes of HCC, such as cellular dysplasia, advancing age and male gender. Others factors are specific to individual diseases. This has been well established for hepatitis B in which viral load, genotype and antigen status are major contributors to increased risk of HCC. For both hepatitis B and hepatitis C attempts have been made to identify those individuals at greatest risk using data from large cohort studies. In addition to the common causes of liver disease that are recognized to be causes of HCC non-alcoholic fatty liver disease and possibly diabetes are newly emerging risk factors.