EDITORIAL Epidemiology and Risk Factors of Hepatocellular Carcinoma in Asia Mamun Al-Mahtab, Helal Uddin, Sheikh Mohammad Fazle Akbar Mamun Al-Mahtab, Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, Shahbagh, Dhaka 1000, Bangladesh Helal Uddin, Clinical Research Organization, Dhaka, Bangladesh Sheikh Mohammad Fazle Akbar, Toshiba General Hospital, Tokyo, Japan Correspondence to: Mamun-Al-Mahtab, Associate Professor, Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, Shahbagh, Dhaka 1000, Bangladesh. Email: shwapnil@agni.com Telephone:+880 171 156 7275 Received: August 23, 2013 Revised: December 31, 2013 Accepted: January 4, 2014 Published online: April 21, 2014 ABSTRACT The dominant form of primary liver cancer is hepatocellular carcinoma (HCC). Its incidence varies widely among different geographical areas (from <2 to >50 per 100,000 males/year), reaching peak values in some countries of Southeast Asia. The incidence, prevalence and risk factors of HCC exhibit marked differences among different countries of Asia and also among different regions of the same country. The numbers of patients with HCC are increasing in many Asian countries. It is expected that the incidence of HCC will also increase in the foreseeable future because the burden of chronic liver disease is increasing owing to increasing rates of hepatitis B and C prevalence, obesity- related fatty liver diseases, alcoholism, and other risk factors. Better understandings about epidemiology and risk factors of HCC in Asian countries would allow development of more effective control and management strategies against HCC in these countries. © 2014 ACT. All rights reserved. Key words: Hepatocellular carinoma; Risk factor; Asia; In- creased incidence Al-Mahtab M, Uddin H, Akbar SMF. Epidemiology and Risk Factors of Hepatocellular Carcinoma in Asia. Journal of Gastroenterology and Hepatology Research 2014; 3(4): 1019-1023 Available from: URL: http://www.ghrnet.org/index.php/joghr/article/view/654 PREFACE (InTRoduCTIon) Primary liver cancer, which consists predominantly of hepatocellular carcinoma (HCC), is a major contributor to cancer incidence and mortality. HCC is the ffth most common cancer worldwide and the third most common cause of cancer mortality. It results in about 0.7 million deaths per year worldwide. Because of its poor prognosis, this number of deaths is almost the same as the number of cases being diagnosed each year (about 0.6 million) [1-3] . There is a growing understanding on the molecular mechanisms inducing hepatocarcinogenesis, which almost never occurs in healthy liver. But, the cancer risk increases sharply in response to chronic liver injury at the cirrhosis stage [3] . Risk factors those may provide fnal and critical assaults for pathogenesis of HCC in diseased and inflamed livers have been elucidated. But, more studies would be needed regarding cellular and molecular mechanisms underlying hepatocarcinogenesis in different races and population groups. The incidence and prevalence of HCC exhibit marked variations among geographic regions, racial and ethnic groups, and between men and women. Most of the HCC patients are detected in Asian and sub-Saharan African countries. Incidence of HCC has been decreasing in some areas of Asia with high prevalence of HCC. This is especially seen in some cities or specific regions of Asian countries [4] . It is assumed that effective HBV vaccination programs and the better control of aflatoxin exposure in the high HCC incidence areas are contributing to the decreased HCC incidence. On the other hand, the incidence of HCC is increasing, mainly because of the increasing prevalence of hepatitis C virus (HCV) infection and immigration of people from countries with high endemicity for hepatitis B virus (HBV) infection. In spite of this variability regarding incidence of HCC in different Asian countries, the total numbers of patients with HCC are increasing in these countries. Increased incidence of HCC, availability of improved diagnostic modalities for HCC, and increased survival resulting from better control and management strategies may have contributed to this phenomenon. Although these changes have been occurred in global context, the nature and characteristics of management strategies are variable among different countries of Asia and even in different parts of same country or region. 1019 Journal of GHR 2014 April 21 3(4): 1019-1023 ISSN 2224-3992 (print) ISSN 2224-6509 (online) Online Submissions: http://www.ghrnet.org/index./joghr/ doi:10.6051/j.issn.2224-3992.2014.03.306 © 2014 ACT. All rights reserved. Journal of Gastroenterology and Hepatology Research