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Textbook of Cancer Epidemiology$
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Hans-Olov Adami, David Hunter, and Dimitrios Trichopoulos

Print publication date: 2008

Print ISBN-13: 9780195311174

Published to Oxford Scholarship Online: September 2009

DOI: 10.1093/acprof:oso/9780195311174.001.0001

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Cancer of the Liver and Biliary Tract

Cancer of the Liver and Biliary Tract

(p.308) 12 Cancer of the Liver and Biliary Tract
Textbook of Cancer Epidemiology

Sherri Stuver

Dimitrios Trichopoulos

Oxford University Press

Primary liver cancer encompasses hepatocellular carcinoma (>90%), cholangiocarcinoma (<10%), and some other rare histologic types. Hepatocellular carcinoma is one of the most common cancers in Southeast Asia and in sub-Saharan Africa, and it is almost uniformly fatal. Chronic infection with HBV and HCV dominates the etiology of the disease in developing countries. Aflatoxin exposure is also likely to contribute to the causation of HCC. In developed countries, alcoholic cirrhosis, cirrhosis of other etiology, and tobacco smoking assume a relatively more important role. Rare chemical exposures, such as inorganic arsenic and vinyl chloride monomer, and, in the past, radiation from the contrast medium Thorotrast have been responsible for a small proportion of cases. Alpha1-antitrypsin deficiency, hemochromatosis, and porphyria cutanea tarda, also increase the risk. Cholangiocarcinoma is linked to chronic infection with O. viverrini and perhaps other liver flukes. Cancer of the extrahepatic bile ducts is closely associated with cholelithiasis and its risk factors, in particular female gender, obesity, and high parity.

Keywords:   Cholangiocarcinoma, HBV, HCV, aflatoxin, cirrhosis, tobacco, alcohol, arsenic, vunyl chloride, liver fluke

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