Liver cancer (hepatocellular carcinoma [HCC]) incidence and mortality rates have been increasing in most countries for several decades. Currently, HCC is the second most common cause of cancer-related death in the world and represents the fastest rising cause of cancer-related deaths in the United States.1 Chronic hepatitis B virus (HBV) and hepatitis C virus are the primary underlying causes of HCC, with contributions from alcohol, tobacco, aflatoxin, obesity, and metabolic syndrome. In patients with chronic hepatitis C virus, the risk of HCC can be reduced rapidly with short-term, direct-acting antiviral medications. In chronic HBV, oncogenesis starts with viral DNA integration into the genome of host hepatocytes that induces a cascade of host responses, including cell injury, necrosis, and angiogenesis, reflected clinically by the levels of serum alanine aminotransferase and HBV DNA, both of which are predictors of HCC.
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Fox RK, Taddei TH, Kaplan DE. Aspirin Use and Risk of Hepatocellular Carcinoma in Hepatitis B. JAMA Intern Med. 2019;179(5):640–641. doi:10.1001/jamainternmed.2018.8314
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