Multifactoral etiology of human liver cancer

Liver cancer is one of the most prevalent forms of cancer in the world. Hepatitis B virus (HBV)* is considered to be a major etiological factor (1,2), and an intervention strategy based on vaccination has been formulated (3). Evidence from epidemiological studies has also indicated that environmental contaminants, such as mycotoxins, may either in combination with HBV or independently be important etiological factors in the pathogenesis of primary hepatocellular carcinoma (PHQ. This commentary is a brief review of the epidemiological and laboratory data that suggest interplay of viral and chemical factors in the multifactoral etiology and pathology of PHC. Areas of uncertainties and future experimentation are identified and a hypothesis of liver carcinogenesis is proposed.