In world terms, the more common primary liver cancer – hepatocellular carcinoma - is a major health problem. In some areas the incidence is approximately 0.5-1% of the population (e.g. some areas in southern Africa and some in the Far East) whereas the incidence in the indigenous population of northern Europe is only 1 per 100,000 of people. In male Chinese carriers of the hepatitis B virus, there may be a lifetime risk of 50% of developing the disease, and exposure to the hepatits virus and some times other predisposing infective agents (e.g. fungal aflatoxin – derived from cereals stored under damp conditions) over a long period of time is unquestionably heavily related to an enhanced incidence of the disease. By contrast for the less common type of liver cancer viz. cholangiocarcinoma (which is a cancer arising from the linings of the bile ducts), a chronic infection with the liver fluke (Clonorchis sinensis) predisposes to this cancer.
