Journal
NATURE REVIEWS GASTROENTEROLOGY & HEPATOLOGY
Volume 11, Issue 1, Pages 45-54Publisher
NATURE PORTFOLIO
DOI: 10.1038/nrgastro.2013.143
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Funding
- NIH [CA100882, CA128633, CA165076]
- Mayo Clinic Center for Cell Signaling in Gastroenterology [NIDDK P30DK084567]
- Mayo Clinic Cancer Center [CA15083]
- Mayo Foundation
- NATIONAL CANCER INSTITUTE [R21CA128633, R01CA165076, R01CA100882, P30CA015083, R56CA100882] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES [P30DK084567] Funding Source: NIH RePORTER
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Hepatocellular carcinoma (HCC) is the third most common cause of death from cancer. The incidence and mortality of HCC are increasing in most Western countries as a result of an ageing cohort infected with chronic hepatitis C, and are expected to continue to rise as a consequence of the obesity epidemic. Chemopreventive strategies aimed at decreasing the risk or delaying the onset of HCC are needed. Universal immunization against HBV and antiviral therapy against HBV and HCV in patients with established disease has consistently been associated with reduced HCC risk, especially in patients who achieve sustained virologic response. However, the cost-effectiveness of antiviral therapy for primary HCC prevention is not known. Several commonly prescribed medications seem promising as chemopreventive agents against HCC, including statins, antidiabetic medications and aspirin. Dietary agents such as coffee, vitamin E and fish oil as well as phytochemicals might also be associated with reduced risk of HCC. Though randomized controlled trials are ideally needed to firmly establish efficacy, such chemoprevention trials are logistically and ethically challenging. Well-designed, prospective, population-based cohort studies might provide the best evidence for chemopreventive efficacy of these agents.
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