Hepatocellular carcinoma is primarily associated with which underlying condition?

Hepatocellular carcinoma (HCC) is primarily linked to chronic liver conditions, with cirrhosis being the most significant risk factor. Specifically, cirrhosis can result from various underlying liver diseases, including infections such as hepatitis B virus (HBV) and hepatitis C virus (HCV), chronic alcohol abuse, and metabolic disorders. The hepatocyte damage caused by these conditions leads to regenerative nodules and potential malignant transformation over time, making cirrhosis a critical factor in the development of HCC.

Additionally, the association with HBV is particularly strong; regions with high prevalence of HBV infections often see a correspondingly high incidence of HCC, especially in individuals who progress to cirrhosis due to the chronic nature of the viral infection. This makes it clear that both cirrhosis and HBV have a direct role in the pathogenesis of hepatocellular carcinoma, underscoring why this combination is deemed the primary underlying condition associated with HCC.

While the other conditions listed, such as diabetes, alcohol use disorder, and nonalcoholic fatty liver disease, can contribute to the risk of liver complications and potentially HCC, none synergistically combine the two factors (cirrhosis and