Changing epidemiology and etiology of hepatocellular carcinoma in Europe: implications for clinical practice and health policy

Primary liver cancer, of which hepatocellular carcinoma (HCC) represents the vast majority, is on the rise globally. Despite an expected decrease in viral hepatitis-related HCCs, the number of new cases and deaths from liver cancer is predicted to increase by over 30% in 2050 in Europe. This is largely driven by an increase in metabolic dysfunction-associated steatotic liver disease-related HCC and an aging population. Since HCC usually develops in patients with underlying chronic liver disease, over half of all cases appear to be preventable by targeting modifiable risk factors. This series paper summarizes epidemiological and etiological trends of HCC in Europe and their implications for the clinical management of HCC across different disease stages. We discuss public health initiatives and policies to counteract the rising incidence of HCC by focusing on prevention, and highlight additional benefits of etiological treatment for the management and prognosis of patients with HCC.