World J Gastroenterol. 2011 Jun 28;17(24):2976. doi: 10.3748/wjg.v17.i24.2976.
Worldwide, the burden of the non viral causes of hepatocellular carcinoma (HCC) is usually underestimated. Clearly industrial goods, tobacco, alcohol and processed foods are the agents of new epidemics in modern times which far outscore the burden of infectious agents on morbidity and mortality. Smoking, a dose-related contributing factor for HCC, receives too little attention in clinical practice. In France, tobacco, hepatitis B and C virus and alcohol are the main risk factors for HCC mortality (33%, 31% and 26%, respectively). In developing countries, where tobacco consumption is dramatically increasing, this epidemic may soon surpass hepatitis B. Obesity and diabetes are the contributing factors too. The role of industrial processed foods in the increase of the prevalence of obesity and diabetes cannot be ignored.
在全球范围内，非病毒性肝癌（HCC）病因的负担通常被低估。显然，工业制品、烟草、酒精和加工食品是现代新出现的流行病因，其在发病率和死亡率方面的影响远超传染病病原体。在临床实践中，与 HCC 相关的剂量相关因素——吸烟，受到的关注太少。在法国，烟草、乙型肝炎和丙型肝炎病毒以及酒精是 HCC 死亡率的主要危险因素（分别为 33%、31%和 26%）。在烟草消费急剧增加的发展中国家，这种流行病可能很快会超过乙型肝炎。肥胖和糖尿病也是促成因素。工业加工食品在肥胖和糖尿病患病率增加方面的作用不容忽视。
