Reverse-engineering precision liver cancer chemoprevention

Hepatocellular carcinoma (HCC) remains one of the major health problems with the NAFLD epidemic and persisting HCC risk even after successful HCV cure. The relatively low annual HCC incidence in these emerging liver disease patient populations has made the guideline-recommended regular HCC screening more challenging. This highlights the urgent need for HCC risk prediction/stratification to enable rational allocation of the limited medical resources for HCC screening to patients who most need it. The diverse HCC etiology and racial/ethnic and socioeconomic disparities across the patients add complexity in the HCC risk prediction and indicate necessity of clinical-context-based risk assessment. In addition, the unique mechanisms of carcinogenesis according to the HCC etiology suggest necessity of chemopreventive measures directed to the specific molecular targets. In this lecture, we will overview recent development in etiology-agnostic and specific HCC risk prediction and molecular targeted chemoprevention strategies under development.