![]() Over this period several mutations accumulate in the cell and that stimulate malign transformation, growth, and metastatic behavior. HCC development is recognized as a multistep process that normally develops over many years. In the second part we look at the molecular processes involved in cancer progression. In this review we focus firstly on the different risk factors for HCC and summarize the mechanisms by which each is considered to contribute to HCC. In around 80% of the cases, HCC is associated with cirrhosis or advanced fibrosis and with inflammation and oxidative stress. A number of risk factors are associated with either the induction of the disease or its progression these include infection with hepatitis B or C virus, alcohol consumption, non-alcoholic steatohepatitis and certain congenital disorders. ![]() Hepatocellular carcinoma (HCC) is a major health problem worldwide responsible for 500 000 deaths annually. ![]()
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