Alcohol and hepatocellular carcinoma: Adding fuel to the flame

Primary tumors of the liver represent the fifth most common type of cancer in the world and the third leading cause of cancer-related death. Case-control studies from different countries report that chronic ethanol consumption is associated with an approximately 2-fold increased odds ratio for hepatocellular carcinoma (HCC). Despite the substantial epidemiologic data in humans demonstrating that chronic alcohol consumption is a major risk factor for HCC development the pathways causing alcohol-induced liver cancer are poorly understood. In this overview we summarize the epidemiological evidence for the association between alcohol and liver cancer review the genetic oncogenic and epigenetic factors that drive HCC development synergistically with ethanol intake and discuss the essential molecular and metabolic pathways involved in alcohol-induced liver tumorigenesis.