Zelber-Sagi Shira, Noureddin Mazen, Shibolet Oren
School of Public Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa 3498838, Israel.
Department of Gastroenterology & Hepatology, Tel Aviv Medical Center, Tel Aviv 6423906, Israel.
Cancers (Basel). 2021 Dec 26;14(1):103. doi: 10.3390/cancers14010103.
The increasing burden of hepatocellular carcinoma (HCC) emphasizes the unmet need for primary prevention. Lifestyle measures appear to be important modifiable risk factors for HCC regardless of its etiology. Lifestyle patterns, as a whole and each component separately, are related to HCC risk. Dietary composition is important beyond obesity. Consumption of n-3 polyunsaturated fatty acids, as well as fish and poultry, are inversely associated with HCC, while red meat, saturated fat, and cholesterol are related to increased risk. Sugar consumption is associated with HCC risk, while fiber and vegetable intake is protective. Data from multiple studies clearly show a beneficial effect for physical activity in reducing the risk of HCC. However, the duration, mode and intensity of physical activity needed are yet to be determined. There is evidence that smoking can lead to liver fibrosis and liver cancer and has a synergistic effect with alcohol drinking. On the other hand, an excessive amount of alcohol by itself has been associated with increased risk of HCC directly (carcinogenic effect) or indirectly (liver fibrosis and cirrhosis progression. Large-scale intervention studies testing the effect of comprehensive lifestyle interventions on HCC prevention among diverse cohorts of liver disease patients are greatly warranted.
肝细胞癌（HCC）负担的日益加重凸显了对其一级预防的未满足需求。无论病因如何，生活方式措施似乎都是HCC重要的可改变风险因素。整体生活方式模式及其各个组成部分分别与HCC风险相关。饮食构成的重要性超出了肥胖因素。摄入n-3多不饱和脂肪酸以及鱼肉和禽肉与HCC呈负相关，而红肉、饱和脂肪和胆固醇则与风险增加有关。糖的摄入与HCC风险相关，而纤维和蔬菜摄入具有保护作用。多项研究数据清楚地表明体育活动对降低HCC风险有有益作用。然而，所需体育活动的持续时间、方式和强度尚待确定。有证据表明吸烟会导致肝纤维化和肝癌，并且与饮酒有协同作用。另一方面，过量饮酒本身直接（致癌作用）或间接（肝纤维化和肝硬化进展）与HCC风险增加有关。非常有必要开展大规模干预研究，以测试综合生活方式干预对不同肝病患者队列中HCC预防的效果。
