Changing Etiology and Epidemiology of Human Liver Cancer

Collectively, liver cancer accounts for 8.2% of all reported cancer deaths in men and women, and it is the third/fourth most common cause of cancer mortality worldwide. Currently, there are more than 840,000 new cases of this nearly always fatal cancer each year. The combined age-standardized rate of mortality from liver cancer for men and women worldwide was 8.5 per 100,000 in 2018. The countries that traditionally are considered as part of the Middle East span two World Health Organization (WHO) regions: Eastern Mediterranean and Europe. Of these countries, Egypt has the second highest age-standardized rate of mortality from liver cancer, 49.0 and 16.7 per 100,000 for men and women, respectively, in the world. Indeed, this mortality rate is only exceeded globally by Mongolia. Further, liver cancer has a poor prognosis, less than a 15% 5-year survival. The etiologies of liver cancer diagnosed today are well understood, and with the emergence of fatty liver disease as a risk factor, this cancer is especially emergent in the countries of the Middle East where a majority of adults are now obese and the rates are rising.