American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the relationship between age and the likelihood of having HCC in patients with chronic HBV infection?

1. Older age does not significantly impact risk

2. Age is only a factor for women

3. Age over 40 in men and over 50 in women increases risk

4. There is no age-related risk in African patients

The correct answer is: Age over 40 in men and over 50 in women increases risk

The relationship between age and the likelihood of having hepatocellular carcinoma (HCC) in patients with chronic hepatitis B virus (HBV) infection is well-established in medical literature. Research indicates that the risk of developing HCC significantly increases with advancing age, particularly for those who are chronically infected with HBV. Specifically, evidence shows that men over the age of 40 and women over the age of 50 exhibit a heightened risk for HCC. This increased risk is attributed to various factors, including the cumulative effects of the viral infection, liver damage over time, and potential co-factors such as underlying liver cirrhosis. As individuals age, the capacity for liver regeneration diminishes, and the likelihood of progression from chronic HBV infection to more severe liver disease, including the development of HCC, increases. In contrast, the other response options either diminish or misinterpret the role of age as a risk factor. They do not account for the established correlation between aging and the likelihood of HCC in chronic HBV patients, thereby neglecting significant epidemiological findings that support the understanding of cancer risk relative to age.