Hepatocellular carcinoma in immigrants to the United Kingdom.
Analysis of the origin of patients with hepatocellular carcinoma admitted to the Liver Unit between 1970 and July 1985 showed an increase in frequency of this tumour in immigrants to the United Kingdom from none between 1970 and 1973, to 15 per cent between 1981 and 1985. The 19 immigrant cases had resided in this country for between four and 28 years and when compared with a group of 30 patients born in the United Kingdom three striking differences emerged. Firstly, the immigrants were significantly younger. Secondly, although the frequency of underlying cirrhosis (approximately 80 per cent) was similar the aetiology differed with HBV-related disease being the largest group (93 per cent) in the immigrants and alcohol or cryptogenic cirrhosis in the other patients amongst whom HBV markers were detected in only 20 per cent. Thirdly, whilst signs and symptoms attributable to hepatocellular carcinoma represented the first evidence of liver disease in 89 per cent of the immigrants, symptoms of cirrhosis in patients born in the United Kingdom had been evident for several years before tumour development.