世界范围内,肝癌是第六大常见癌症,在癌症相关性死亡原因中排第二。[1]World Health Organization/Globocan 2012 (IARC). Liver cancer: estimated incidence, mortality and prevalence worldwide in 2012. 2016. http://globocan.iarc.fr/ (last accessed 21 August 2016).http://globocan.iarc.fr/old/FactSheets/cancers/liver-new.asp肝癌在世界各地的发病率因乙型肝炎和丙型肝炎患病率不同而各异。根据最新的 2012 年 Globocan 数据,全球肝癌负担的 83% 来自于欠发达地区。[1]World Health Organization/Globocan 2012 (IARC). Liver cancer: estimated incidence, mortality and prevalence worldwide in 2012. 2016. http://globocan.iarc.fr/ (last accessed 21 August 2016).http://globocan.iarc.fr/old/FactSheets/cancers/liver-new.asp美国肝癌发病率在过去 20 年里因丙型肝炎的传播而增加,在 45 岁到 60 岁的人群中增长最快。[2]El-Serag HB, Kanwal F. Epidemiology of hepatocellular carcinoma in the United States: where are we? Where do we go? Hepatology. 2014;60:1767-1775.http://onlinelibrary.wiley.com/doi/10.1002/hep.27222/fullhttp://www.ncbi.nlm.nih.gov/pubmed/24839253?tool=bestpractice.com[3]El-Serag HB, Davila JA, Petersen NJ. The continuing increase in the incidence of hepatocellular carcinoma in the United States: an update. Ann Intern Med. 2003;139:817-823. [Erratum in: Ann Intern Med. 2004;140:151.]http://annals.org/article.aspx?articleid=716924http://www.ncbi.nlm.nih.gov/pubmed/14623619?tool=bestpractice.com[4]El-Serag HB, Mason AC. Rising incidence of hepatocellular carcinoma in the United States. N Engl J Med. 1999;340:745-750.http://www.ncbi.nlm.nih.gov/pubmed/10072408?tool=bestpractice.com美国肝癌发病率经年龄校正后为 6 例/每 10 万人。[3]El-Serag HB, Davila JA, Petersen NJ. The continuing increase in the incidence of hepatocellular carcinoma in the United States: an update. Ann Intern Med. 2003;139:817-823. [Erratum in: Ann Intern Med. 2004;140:151.]http://annals.org/article.aspx?articleid=716924http://www.ncbi.nlm.nih.gov/pubmed/14623619?tool=bestpractice.com在欧洲,发病率大约为 8.29 例/每 10 万人。[5]Parikh P, Malhotra H, Jelic S; ESMO Guidelines Working gGroup. Hepatocellular carcinoma: ESMO clinical recommendations for diagnosis, treatment and follow-up. Ann Oncol. 2008;19(suppl 2):ii27–ii28.http://annonc.oxfordjournals.org/cgi/reprint/19/suppl_2/ii27http://www.ncbi.nlm.nih.gov/pubmed/18456757?tool=bestpractice.com在英国,每年大约有 1500 名患者因肝癌而死亡。[6]Ryder SD; British Society of Gastroenterology. Guidelines for the diagnosis and treatment of hepatocellular carcinoma (HCC) in adults. Gut. 2003;52(suppl 3):iii1-iii8.http://gut.bmj.com/content/52/suppl_3/iii1.longhttp://www.ncbi.nlm.nih.gov/pubmed/12692148?tool=bestpractice.com肝癌在男性中较女性多见,这可能因为诸如像雄激素这样的危险因素有性别上的差异。[7]Tanaka K, Sakai H, Hashizume M, et al. Serum testosterone:estradiol ratio and the development of hepatocellular carcinoma among male cirrhotic patients. Cancer Res. 2000;60:5106-5110.http://cancerres.aacrjournals.org/content/60/18/5106.fullhttp://www.ncbi.nlm.nih.gov/pubmed/11016636?tool=bestpractice.com在美国和欧洲,诊断为肝癌患者的平均年龄是 60 岁。[8]Tsukuma H, Hiyama T, Tanaka S, et al. Risk factors for hepatocellular carcinoma among patients with chronic liver disease. N Engl J Med. 1993;328:1797-1801.http://www.nejm.org/doi/full/10.1056/NEJM199306243282501#t=articlehttp://www.ncbi.nlm.nih.gov/pubmed/7684822?tool=bestpractice.com在亚洲,平均在 50 岁到 60 岁,而在撒哈拉以南的非洲,平均年龄为 33 岁。[9]El-Serag HB. Hepatocellular carcinoma: an epidemiologic view. J Clin Gastroenterol. 2002;35(suppl 2):S72-S78.http://www.ncbi.nlm.nih.gov/pubmed/12394209?tool=bestpractice.com