Hepatocellular carcinoma in the developing world

There has recently been an observable increase in some forms of cancer the world over. This is attributable in large part to the introduction of acquired immunodeficiency syndrome (AIDS)-related malignancies into the world of medicine and it is interesting that most of these cases are seen in the developing world, which proportionately leads with the number of AIDS cases. Despite this, some more traditional cancers remain the big killers in these areas of the world, except that in some countries definitive interventions have yielded excellent results in reducing disease burden. In Africa and the developing world, hepatocellular carcinoma (HCC) is the leading cause of cancer death, having some clearly established etiologic factors. This review describes the current status of each of these known etiologic factors in the various areas and, using available evidence, suggests options that may be employed to further stem the incidence of HCC and improve on survival in these populations. Semin Oncol 28:179-187.