Qidong Liver Cancer Insititute, Qidong People's Hospital, Affiliated Qidong Hospital of Nantong University, Qidong, 226200, People's Republic of China.
Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, WA, 98109, USA.
Curr Oncol Rep. 2024 Nov;26(11):1452-1468. doi: 10.1007/s11912-024-01605-7. Epub 2024 Oct 10.
This review aims to synthesize the old issues and current understandings of the etiology of liver cancer, focusing on the diverse causative factors influenced by geographical, socioeconomic, and lifestyle variations across different regions.
We highlight significant geographic disparities in liver cancer risk factors. While hepatitis B and C viruses, aflatoxin exposure, and alcohol consumption remain globally established contributors; metabolic dysfunction-associated steatotic liver disease and metabolic syndromes are increasingly prominent in the West. Chronic HBV and aflatoxin continue to dominate as risk factors in Asia and Africa. Dietary factors, metabolic diseases like diabetes and obesity, genetic predispositions, environmental risk factors and lifestyle choices such as smoking and alcohol use play substantial roles in specific populations. Protective factors like coffee and tea consumption, along with aspirin use, vegetables and fruits have shown potential in reducing HCC risk, although findings vary by population and dietary habits. Liver cancer etiology is influenced by various factors that differ by region. Established risk factors include hepatitis B and C, aflatoxin, and alcohol. Emerging risks, such as metabolic dysfunction-associated steatotic liver disease, are more prevalent in Western countries, while aflatoxin and HBV remains significant in Asia and Africa. Diet, metabolic conditions like diabetes and obesity, genetic predispositions, and lifestyle choices also play crucial roles. Coffee, tea, aspirin, vegetables, and fruits may reduce HCC risk, but effectiveness varies. Future research should integrate epidemiology, genetics, and nutrition, with global cooperation and data sharing essential for effective cancer control strategies.
本文旨在综合肝癌病因学的旧问题和当前认识，重点关注不同地区地理、社会经济和生活方式差异所影响的多种致病因素。
我们强调了肝癌危险因素的显著地域差异。虽然乙型肝炎和丙型肝炎病毒、黄曲霉毒素暴露和酒精摄入仍然是全球公认的致病因素；但代谢功能障碍相关的脂肪性肝病和代谢综合征在西方越来越突出。慢性 HBV 和黄曲霉毒素仍然是亚洲和非洲的主要危险因素。饮食因素、糖尿病和肥胖等代谢疾病、遗传易感性、环境危险因素和生活方式选择（如吸烟和饮酒）在特定人群中起着重要作用。咖啡和茶的摄入、阿司匹林的使用、蔬菜和水果等保护因素显示出降低 HCC 风险的潜力，但研究结果因人群和饮食习惯而异。肝癌病因受多种因素影响，这些因素因地区而异。已确定的危险因素包括乙型肝炎和丙型肝炎、黄曲霉毒素和酒精。新兴的风险因素，如代谢功能障碍相关的脂肪性肝病，在西方国家更为普遍，而黄曲霉毒素和 HBV 在亚洲和非洲仍然是重要的危险因素。饮食、糖尿病和肥胖等代谢状况、遗传易感性和生活方式选择也起着至关重要的作用。咖啡、茶、阿司匹林、蔬菜和水果可能降低 HCC 风险，但效果因人群和饮食习惯而异。未来的研究应综合流行病学、遗传学和营养学，全球合作和数据共享对于制定有效的癌症控制策略至关重要。
