b'Risk Factors Change for HCCWith More Effective Hepatitis C TreatmentRisk factors for hepatocellular carcinoma have undergone dramatic changes in recent years. Metabolic conditions such as obesity and diabetes, as well as associated nonalcoholic fatty liver disease, now sitat the top of the list. Alcohol use disorders also are on the increase, fueling alcoholic liver disease and alcoholic cirrhosis.By Jennifer MarquezHOUSTONMost cases of hepatocellular carcino- SurveillanceCohort. Thestudyauthorscalculated ma (HCC), the most common form of primary liverthe annual overall incidence rate for HCC and also cancer, occur in patients with cirrhosis. Yet cirrhosis,examined how etiology, demographic, clinical and or scarring of the liver tissue, can develop for a num- lifestyle factors affected patient risk. 1ber of reasonsand the most predominant risk fac- Thecontributingriskfactorsforcirrhosishave tors have changed significantly in the United Stateschanged,saidFasihaKanwal,MD,thestudys over the past decade.firstauthor,aninvestigatorattheVACenterfor Metabolic conditions like obesity and diabetes, asInnovationsinQuality,EffectivenessandSafety wellasnonalcoholicfattyliverdisease(whichisattheMichaelE.DeBakey VAMCandprofessor associatedwiththesemetabolicconditions),haveofmedicineatBaylorCollegeofMedicine,both becomethetopriskfactorsfor cirrhosis. Rising rates of alcohol usedisordersalsohavefueled anincreaseinalcoholicliver diseaseandalcoholiccirrhosis. Meanwhile,untreatedhepati-tis C and hepatitis B infections, which can lead to cirrhosis, have decreased in prevalence. Whileexpertsexpectthat changes in cirrhosis risk factors could translate to shifts in the cir-rhosis patients risk ofHCC, a new study is among the first to ana-lyze data related to these trends. Theresearch,whichwaspub-lished in the journal Hepatology, looked at 2,733 cirrhosis patients, usingdatafromtwocontem-porary,multiethnicpatient cohorts: the Texas Hepatocellular CarcinomaConsortiumCohort Source: Stice CP, Xia H, Wang XD. Tomato lycopene prevention of alcoholic fatty liver disease and hepatocellular carcinoma andtheHoustonVACirrhosisdevelopment. Chronic Dis Transl Med. 2018;4(4):211-224. Published 2018 Dec 18. doi:10.1016/j.cdtm.2018.11.00188'