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Hepatocellular carcinoma is the fifth most frequent and third most frequent cause of death from cancer, with a prevalence of about 1 million cases per year . Hepatocellular carcinoma is the second leading cause of death from cancer in men and sixth among women in the world . The incidence ranges from 2/100 000 in Europe and up to 30/100 000 cases per year in endemic regions for viral hepatitis B and C (Southeast Asia and Africa). Men suffer 4-10 times more often than women. Any patient with chronic liver disease is at high risk for hepatocellular carcinoma. In liver cirrhosis, the prevalence of hepatocellular carcinoma is 2-60% .
About 80% of cases of hepatocellular carcinoma are associated with chronic viral hepatitis. In chronic viral hepatitis B, the risk of hepatocellular carcinoma increases by 5–15 times, and in chronic viral hepatitis C - by 11.5–17 times, compared with individuals without chronic viral hepatitis . According to data obtained during a 30-year follow-up in liver cirrhosis caused by chronic viral hepatitis C, the risk of developing hepatocellular carcinoma annually increases by 1-4% .The age at which hepatocellular carcinoma debuts varies greatly in different parts of the world. The development of hepatocellular carcinoma after 60 years is typical for the countries of North America, the European Union and Japan. Whereas in most African and Asian countries, hepatocellular carcinoma is detected in 30-60 years. A study conducted on 18,031 patients from 14 countries of the world showed the average age at which hepatocellular carcinoma debuted for Japan was 69 years, for Europe 65 and for North America 62 years, for South Korea 59 years and for China 52 years, respectively . Data from a cohort study of 1552 patients in Africa, published in 2015, showed an average age of hepatocellular carcinoma onset of 45 years . It should be noted that, unlike other more common neoplasms that tend to reduce the incidence, the incidence of hepatocellular carcinoma is increasing . Hepatocellular carcinoma is often asymptomatic, and the onset of symptoms can signal the development of a serious illness. In this case, hepatocellular carcinoma is often diagnosed already in stage B or C. It should be noted that in some patients with small tumors decompensated cirrhosis is often noted .
Clinical signs and symptoms of liver cirrhosis, which is often present in patients with hepatocellular carcinoma and obscures the presence of antecedent early hepatocellular carcinoma .